Career

I have applied for a position with Peace of Mind Professional Service. I have been requested to provide information for their use in reviewing my background and qualifications. Therefore, I hereby authorize the investigation of my past and present work character, education, military and employment qualifications.

I authorize the release of my information to Peace of Mind Professional Service whether the information is of record or not, and I do hereby release all persons, agencies, firms, companies, etc., from any damages resulting from providing such information.

This authorization is valid for 180 days from the date below. Please keep this copy of my release request in your files.

If you are offered and accept employment with Peace of Mind Professional. in the interest of safety for all concerned, you will be required to take a urine test for drug and / or alcohol screening.

I have been fully informed of the reason for this urine test for drug and/or alcohol screening. I fully understand what I am being tested for, the procedure involved, and do hereby freely give my consent. In addition, I understand that the results of this test will be forwarded to my potential employer and become part of my record.

If this test is positive and l am not hired. I understand that I will be given the opportunity to explain the results of this test.

I hereby authorize these test results to be released to:

Peace of Mind Professional Service

a) After expiration or termination of employment agreement I agree to respect the confidentiality of Peace of Mind Professional Service customer lists, trade secrets, or other confidential information, and not to disclose them to anyone.

b) I agree not to make use of research done in the course of 180 days while employed by a competitor of Peace of Mind Professional Service.

c) I agree not to set up in business as a direct competitor to Peace of Mind Professional Service within 50 miles of Peace of Mind Professional Service for a period of 1 year following the expiration of termination of employment. For the purpose of this covenant not to compete, competition is defined as soliciting or accepting employment by, or rendering professional services to, any person or organization that is or was a client of Peace of Mind Professional Service during the term of my work with Peace of Mind Professional Service.

d) I agree to pay liquidated damages of $1,000 per month for 12 months for a total of $12,000 (twelve thousand dollars) if any violation of this paragraph is proved or admitted for ach documented violation.

By signing below, you acknowledge that you have read, understood, and will comply with the above provisions. You also understand that you will be held accountable for upholding these.