Failure to Answer These Questions Truthfully May Result in Forfeiture of Worker’s Compensation Benefits Under R.S. 23:1208.1
APPLICANT ACKNOWLEDGEMENT OF TERMS AND CONDITIONS OF APPLICATION
IT IS VERY IMPORTANT THAT YOU READ THIS SECTION CAREFULLY, AND THAT YOU FULLY UNDERSTAND IT BEFORE YOU SIGN IT. THIS SECTION AFFECTS YOUR LEGAL RIGHTS. IF YOU HAVE ANY QUESTIONS, PLEASE ASK A TALA MARINE REPRESENTATIVE BEFORE YOU SIGN THIS APPLICATION.
In exchange for Tala Marine, LLC consideration of this employment application:
All information I have supplied in this application and any other form, oral or written, is true and accurate, and I agree that any misstated, misleading, incomplete, or false information is grounds for rejection and destruction of this application form, refusal to hire, withdrawal of an offer of employment, or immediate discharge without recourse, whenever and however discovered. I make this promise because I understand that you will rely on my statements to you in making your decision whether to hire me.
I understand and agree that Tala Marine, LLC and any agent acting on their behalf, as well as any other person responding to a reference request pursuant to this application, can and will seek and/or disclose any and all information about me which said corporation, agent, or person may have. I specifically authorize said disclosure and agree to hold all such corporations, agents or persons harmless for same. That is, I will not file a lawsuit, claim or charge against them for disclosure. Nor will I threaten same or otherwise seek any kind of compensation for such disclosure.
I certify that Tala Marine, LLC has my permission to implement any screening procedures that the company deems necessary. I understand that all the information obtained from such screening procedures will be used in determining my qualification for employment.
I understand that I can request from Tala Marine, LLC a copy of Tala Marine, LLC employee handbook, and that if I so desire, I can review said handbook before I submit this employment application (In-house Viewing). I agree to abide by the terms and conditions of all Tala Marine, LLC rules and regulations, including without limitation: the requirements that any accident, or any injury, no matter how minor, be immediately reported to supervision.
In the event that I am employed by Tala Marine, LLC I agree to abide by all of its policies, procedures, rules, and regulations, and agree not to disclose any confidential information regarding operating, trade secrets or personal information.
I understand that this form does not indicate there are positions open and does not in any way obligate Tala Marine, LLC to the applicant. If further understand that any such future employment is terminable by either party at will or without notice or cause. No person other than the president of Tala Marine, LLC may modify or amend the provisions stated herein.
I specifically authorize Tala Marine, LLC to investigate my background, including any and all references available, criminal and other judicial records, and my credit record, where applicable to the position for which I am applying and consistent with applicable law. I understand that Tala Marine, LLC will notify me when a credit record investigation is performed, and the sources investigated. I authorize Tala Marine, LLC to use all legal means at its disposal to assess my suitability for employment. I make this authorization in return for Tala Marine, LLC consideration of me for employment, and I specifically release and hold Tala Marine, LLC harmless for any and all liabilities arising out of their investigation of my application for employment.
I understand and agree that work schedules and requirements may vary and be unpredictable, and that, while Tala Marine, LLC will make reasonable efforts to accommodate work schedules and employee availability, I may be required to work overtime, weekends, different shifts, or other arrangements. I understand and agree to working up to 12 hours (either consecutive or otherwise) in a 24 hour period. I consent to these requirements as necessary and legitimate conditions of employment.
I hereby acknowledge that I have read and fully understand the above and hereby state that I will abide by any procedures and policies of Tala Marine, LLC and any falsifications or misrepresentation on this application shall be cause for immediate dismissal