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Please describe the duties you have performed in previous positions, which demonstrates that you have the knowledge, skills, and abilities to perform the essential functions and duties of the job for which you are applying. You may include internships, verifiable volunteer activities, self employment, and military experience. Please include any periods of unemployment. Additional pages of work history may be attached if necessary. A resume is not a substitute for this section of the application but may be attached. Do not write "see resume".

I certify that all of the information furnished in this employment application and its addenda are true and compete to the best of my knowledge. I understand that the City of Huber Heights may investigate the infomation in this application and/or its addenda may lead to revocation of any employment offer or termination after employment.

I hereby acknowledge that I, voluntarily and of my own free will, have applied for employment with the City of Huber Heights with the understanding that the Citymay use a variety of screening procedures to evaluate my qualifications and suitability for appointment. I have been advised that these screening procedures might include, but are not limited to interviews, criminal record checks, driving record checks, polygraph examinations, written testing, reference checks, background investigations, financial and credit check conducted in accordance with the Fair Credit Reporting Act, psychological evaluations, medical examinations, and drug testing. I hereby acknowledge that I would not be required to actually participate in a psychological evaluation, medical examination, or drug test unless I receive a conditional offer of employment. I also acknowledge that any such screening procedures, as reasonably required by the City of Huber Heights, are prerequisites to my appointment to a position with the City of Huber Heights.

In addition, I also hereby understand that the City of Huber Heights cannot guarantee the confidentiality of the results of, or information obtained through, the aforementioned screening procedures. Decisions of the Ohio Supreme Court regarding the Public Records Act indicate that, with certain enumerated exceptions, records maintained by a governmental entity are a matter of public record and, should a proper request be made by a member of the public for such records,k the governmental entity would be required to make such records available to that member of the public within a reasonable time. Employment-related documents, with the exception of certain medical records and some personal identifiers, maintained by the City relative to the aforementioned screening procedures, do not appear to fall within any of the enumerated exceptions.

Therefore, in consideration of my employment application being reviewed by the City of Huber Heights, under no legal disability, and on behalf of my heirs and assigns, hereby release and agree to hold harmless the City of Huber Heights and any of its agents, employees, or related officials from any and all liability, whatever the type and nature, resulting from the administration of any such screening procedures and/or the release of the results therefrom.

Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.