Inquiry Authorization:
I hereby apply for employment with Mohawk Valley Community Action Agency, Inc. Any false statements or omissions made in this application will be considered sufficient cause for dismissal upon discovery thereof.
I hereby authorize Mohawk Valley Community Action and/or its represntatives to make inquiry of all persons, schools, companies, corportations, cosumer reporting agencies, law enforcement agencies, motor vehicle reports, and medical advisors of this company, to supply all information concerning my character prior to employment, general reputation, personal characteristics, and mode of living, and to furnish reports thereon. If employed by Mohawk Valley Community Action Agency, Inc., I will follow the rules and regulations and will agree to physical and medical examinations at the option of the employer, and also agree that the examining physical awill disclose to the employer or its representatives, the results of such examination.