Living with Purpose of Missouri, Inc. is an Equal Opportunity Employer and selects the best matched individual for the job based upon job related qualifications regardless of race, color, creed, sex, age, national origin, handicap, or other protected group under state and federal equal opportunity laws.

I understand and agree:

1. Living with Purpose of Missouri, Inc. will make a thorough investigation of my entire work history and may verify all data given in my application for employment, related papers, and/or oral interviews. I authorize such investigation and the exchange of information requested by Living with Purpose of Missouri, Inc. and I release from liability any person giving or receiving any such information. I understand that falsification of data so given or derogatory information discovered as a result of this investigation may prevent my being hired or, if hired, may subject me to immediate

2. With appropriate consent(s), I authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the duties of a job for which I am being

3. After a conditional offer of employment has been made with Living with Purpose of Missouri, Inc., I further understand and agree:
   • to take a medical examination and/or drug screening by a qualified physician at the discretion of my employer;
   • that, although management makes every effort to accommodate individual preferences and religious beliefs, business needs, at times, may require overtime, shift work, rotating work schedules and locations, holiday work, or a work schedule other than Monday through Friday;
   • that this is an application for employment and that no employment contract is offered or implied;
   • that if I become employed, such employment is for no definite period of time and that Living with Purpose of Missouri, Inc. may change wages, benefits and conditions of employment at any time;
   • if hired, I agree to understand that “punching in” is done electronically on a time clock system; and,
   • if hired, I may be asked to sign a non-compete contract under company

4. I further agree to maintain confidentiality for information regarding service recipients and employees of Living with Purpose of Missouri, Inc. I understand violations of these rules may result in justification for refusal of employment, criminal prosecution, civil penalties, disciplinary action and/or termination of employment from Living with Purpose of Missouri, Inc.

I authorize Living with Purpose of Missouri, Inc. to conduct the following:

• contact all personal and professional references identified on this application;
• perform a driver’s license check on the DMV website prior to possible employment, and if hired, annually or as needed basis thereafter, to ensure my driver's license is valid; and,
• check the MISSOURI Abuse, Felony and Sexual Offender

PROVIDER STAFF PROTECTION FROM HARM STATEMENT

I certify and affirm that to the best of my knowledge and belief I (check one)

CONSENT TO DRUG SCREENING

I consent to a drug screening as terms of my possible employment with this company. Further, I understand that:

• I may be subject to random drug screening at any given time during my employment;
• failure to comply with the drug screening program may be cause for disciplinary action, up to and including termination; and,
• a positive drug screening may be cause for termination or denial of employment.