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For Now & Forever
Please give an accurate, complete full-time and part-time employment record. Start with present or most recent
I certify that this application was completed by me and that the facts set forth in this application are true
and correct and agree that you may investigate my statements. I understand and agree that
misrepresentation or omission of facts on this application will be cause for disqualification from
consideration or immediate dismissal from Rogers Enterprises, Inc. at any time it becomes known. I
understand and agree that as a part of the Company’s procedures for processing employment
applications, an inquiry will be made which will provide applicable information concerning my past job
performance. I authorize any agencies, companies, past employers, schools or persons named in this
application or otherwise to give any information regarding my employment, education, conviction records
or character. I hereby release the Company and said agencies, companies, past employers, schools or
persons from all liability for any damage resulting from using this information. I understand and agree
that my employment and, if employed, my continued employment is conditioned upon participating in
and clearing such background security examinations and/or investigations as may be deemed advisable by
the Company. I agree to participate in such examinations and/or investigations when requested to do so
by the Company. I agree that the Company shall be held harmless and hereby release the Company from
all liability that may arise in connection with any security examination and/or investigation in which I may
be involved. If I am offered employment, I give my permission and will participate in a drug screening
exam and consent to the release of any and all medical information as may be deemed necessary by the
Company, in judging my capability to do the work for which I am applying.
I understand and agree that nothing in this employment application or in the granting of an interview
creates an employment contract between the Company and myself for either employment or for the
providing of any other benefit. I understand no store Manager or representative of the Company other
than the President has any authority to enter into any agreement for employment for any specified period
of time or to make any agreement contrary to the foregoing.
I understand that no such promise or guarantee is binding upon the Company unless made by the
Company President in writing prior to the date of this application. I understand that my employment is
terminable “at will”, that is, the Company retains the right to terminate my employment at any time, with
or without cause and without notice.
NOTICE TO APPLICANTS AND EMPLOYEES: screening tests for alcohol and illegal drug use may be
required before hiring and during your employment.
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