Explain any "yes" answer by providing the year of the conviction, the type of
conviction and the outcome of the crime or offense.
Please explain any "yes" answer.
INSTRUCTIONS FOR ANSWERING CRIMINAL CONVICTION ENQUIRIES
: Do not identify convictions under California
health & safety code 11357(b) or (c), 11360(b) (formerly subdivision (c) of
section 11360), 11364, 11365 or 11550 related to marijuana offenses that occur
two or more years before the instant application. Also, do not identify any
conviction for which the record has been judicially ordered sealed, expunged or
statutorily eradicated, or any misdemeanor conviction for which probation has
been successfully completed or otherwise discharged and the case has been
: Do not identify any guilty plea that was discharged
by the court under Georgia First Offender Act.
: Applicants are neither requested or required to
provide information about any convictions or arrests that are part of records
that have been sealed or expunged.
New York Applicants
: You may answer "no record" concerning any criminal
proceedings that terminated in your favor, per section 160.50 of the New York
Criminal Procedure Law; any criminal proceeding that terminated in a "youthful
offender adjudication," as defined in section 720.35 of New York Procedure Law;
and any conviction for a "violation" that already has been sealed by the court,
per section 160.55 of the New York Procedure Law.
I certify that all the information furnished in this application (and accompanying
documents, if any) is true, complete and correct. I understand and agree that any
falsification, misrepresentation, misleading statement or omission of fact on either
this application or during the pre-hire process will be sufficient reason for disqualification
from further consideration or for termination of employment.
I authorize all persons, schools, companies, corporations and organizations named
in this application (and accompanying documents, if any), to release any information
concerning my background, and I hereby release them and DialAmerica from
any and all claims of liability in law and in equity that may arise out of the release and
attainment of such information.
I understand that if employed, I must produce proper documentation to verify my
eligibility to work in the United States and that if proper documentation is not
produced within three (3) days of employment, termination will occur until such
time as proper documentation is supplied.
I understand that if hired, my employment at DialAmerica would be "at will" and
that nothing in this application or any other DialAmerica document, or an offer or
acceptance of employment, creates or is an employment contract between
DialAmerica and me. I understand that my employment would be for no fixed
duration, and could be terminated by me or DialAmerica at any time without cause,
reason, notice or other procedural requirement. I understand that no oral or written
statement to the contrary shall change this relationship, or should be relied upon by
I understand that DialAmerica may conduct, or have a third party conduct, a
background investigation on me. I further understand that any offer of employment,
or subsequent employment, is conditioned upon DialAmerica’s satisfaction
with the results of any such investigation.
I understand that this application for employment will only be considered for 45
days from the date it is submitted. Should I wish to be considered for employment
beyond this time period, I must submit a new application.
I understand and agree that DialAmerica has the right to unilaterally modify and
/ or terminate any policies, practices, procedures and standards it has adopted or
implemented, to the extent not limited by law.