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Zimmerman Advertising



In the event I am selected for hire for a position with Zimmerman Advertising, Inc. and as a pre-employment condition, I consent to have some or all consumer reports made as to my credit history, employment history, motor vehicle driving record, social security information, criminal record, and other pertinent information for employment purposes, including initial hiring decisions, promotions, reassignments, and/or retention. I hereby authorize Zimmerman Advertising, Inc. to obtain a background report containing the foregoing information from LexisNexis Screening Solutions Inc., consumer center, p.o. box 105108, Atlanta, GA 30348-5108, 800-845-6004.

I am aware that the background report I consent to have prepared may include information obtained from a variety of sources, including but not limited to government agencies, national credit reporting agencies, and others. I am aware that if I choose, I may obtain a complete disclosure of the nature and scope of any report prepared about me if I make a written request to express screening within a reasonable time after I execute this authorization.

I also authorize and request every person, firm, company, corporation, governmental agency, court, law enforcement office, and any other entity having control or possession of any information pertaining to me or my background to furnish the same to any requesting party.

By this authorization for release of information and for the procurement of a background report, I hereby forever release, discharge, exonerate, hold harmless and indemnify express screening, its affiliates, employees, representatives, agents, and subcontractors, and any other person, entity, organization or institution furnishing information to them from any and all liabilities of every nature and kind, including but not limited to claims for libel, slander, invasion of privacy, related tort claims, misuse of information obtained from express screening, and any other claim or cause of action arising out of the furnishing, inspection or copying of any documents, files, records, and other information, or the investigation made by or on behalf of express screening, unless such release is determined to violate the public policy of the state or federal district in which this contract is executed, and in that event, this release will be permitted to the maximum extent allowed by the governing law.

With regards to drug screening, I hereby consent to submit to urinalysis and/or tests as shall be determined by Zimmerman Advertising in the selection process of applicants for employment, for the purpose of testing for illegal drugs or alcohol.

I agree that a Zimmerman Advertising selected vendor may collect these specimens for these tests and may test them or forward them to a testing laboratory designated by the organization for analysis.

I further agree to and hereby authorize the release of the results of said tests to Zimmerman Advertising. I understand that a positive, confirmed test for illegal drugs or alcohol will prohibit me from being employed at this organization.

I further agree to hold harmless Zimmerman Advertising, Inc. and its agents (including the above named physician or clinic) from any liability arising in whole or part out of the collection of specimens, testing, and use of the information from said testing in connection with the organization’s consideration of my employment application.

I further agree that a reproduced copy of this pre-employment consent and release form shall have the same force and effect as the original.

I have carefully read the foregoing and fully understand its contents and I acknowledge this is a voluntary act on my part and that I have not been coerced into signing this document by anyone.

I understand that this electronic consent will be considered as valid as an original signature.

I certify the information given by me to Zimmerman Advertising during my application process and the hiring process is true and complete in all respects. I understand that any misrepresentation or omission of facts on my application, on my resume or during any stage of the hiring process will eliminate me from further consideration or, if discovered after hire, may result in the termination of my employment.

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