had a case of abuse, neglect, mistreatment, or exploitation substantiated against me. As a condition of submitting this application and in order to verify this affirmation, I further release and authorize The Arc Mid-South, the Tennessee Department of Intellectual and Developmental Disabilities, and the Bureau of TennCare to have full and complete access to any and all current or prior personnel or investigative records, from any party, person, business, entity, or agency, whether governmental or non-governmental, as pertains to any substantiated allegations against me of abuse, neglect, mistreatment, or exploitation, and to consider this information as may be deemed appropriate. This authorization extends to providing any applicable information in personnel or investigative reports concerning my employment with this employer to my future employers who may be Providers of DIDD’ services. If I have had a such a case held against me, my explanation can be found below:
❖ The Arc Mid-South is an equal opportunity employer and will consider applicants for all positions without regard to race, age, color, religion, marital status, national origin, disability, veteran status, or any other legally protected status.
❖ No applicant will be rejected as a result of any impairment, which, with reasonable accommodation, does not prevent performance of the work.
❖ The Arc Mid-South will not tolerate sexual harassment or harassment on the basis of any protected status in the workplace.
❖ I understand that, if selected, I will be required to provide proof of my identity and legal right to work in the United States prior to actual employment at The Arc Mid-South.
❖ I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any misrepresentation or material omission on the application will result in my being eliminated from further consideration. I further understand that, if selected for employment, any misrepresentation or material omission that becomes known to The Arc Mid-South may result in immediate termination of my employment.
❖ I hereby authorize all previous employers and supervisors, including all persons with and for whom I have worked, to give The Arc Mid-South’s representatives any and all information regarding me and my previous employment. I release The Arc Mid-South and all previous employers and supervisors from liability for any damages that may result from furnishing information to The Arc Mid-South.
❖ In consideration of my employment, I agree to adhere to all existing and future instructions, rules, and policies of The Arc Mid-South. I also understand that The Arc Mid-South reserves the right to change wages, hours, and working conditions as deemed necessary and that no representative of The Arc Mid-South has any authority to enter into any agreement for employment for any specified period or to make any agreement contrary to the foregoing.
❖ I understand that all employees of The Arc Mid-South, with respect to length of employment, are considered to be “at will”. This means that I may terminate my employment with The Arc Mid-South at any time, without notice, without liability, for any extended period. Similarly, The Arc Mid-South may terminate my employment with The Arc Mid-South at any time without notice, without liability, for any extended period. There is no guaranteed length of employment for any employee. Similarly, any representation by any agent or employee of The Arc Mid-South to the contrary is not authorized or binding upon The Arc Mid-South unless in writing and signed by the Executive Director and/or the Board of Directors of The Arc Mid-South.
