Fuddruckers Application For Employment Page 3
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3I hereby certify that the foregoing statements are true and correct and I understand that any false statement or omission may be
considered as sufficient cause to reject this application or for dismissal from employment if such false statement or omission is
discovered subsequent to the beginning of my employment. I release Luby’s from any and all liability arising from the release of any
rd
information contained on this application to 3
parties. I further understand that during the course of my employment, Luby’s may elect
to obtain an “investigative consumer report,” as defined by the Fair Credit Reporting Act (FCRA). This consumer report may include,
but not be limited to, my personal background and credit information through credit agencies, records search, or other sources for
purposes related to this application for employment or my continued employment including hiring, promotion, transfer, reassignment, or
retention. In the event that I am employed, I agree to comply with all company policies and standards and understand that attendance is
an essential function of any job at Luby’s. I acknowledge that Luby’s policies prohibit harassment and discrimination of any kind and
that, if hired, I must report any instances of harassment or discrimination of which I am aware. I also understand that the use of illegal
drugs or alcohol on the job is prohibited during employment.
Signature of Applicant
Date
Manager taking application_____________________________________________________________________________
Was applicant hired?
Yes
No
This application will remain in active file for 90 days. This information must be kept on file for 2 years.
Equal Opportunity Employer
HR Form No. 201(revised 09/2002, 08/2007, 09/2010) Emp App
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