VICTOR COMMUNITY SUPPORT SERVICES, INC.
GRASS VALLEY, CA
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The Agency`s policy is to fill every position without regard to race, color, religion, creed, sex, marital status,
age, national origin, ancestry, physical handicap or any other consideration made unlawful by federal, state, or
local laws. This Agency is an equal opportunity employer and selects employees on the basis of ability,
experience, training, intelligence and character. Please contact the Executive Director if you have any
questions or complaints regarding this policy.
I, verify that the information I provided on this application is true and correct to best
of my knowledge. I authorize the Agency to conduct an investigation into the accuracy of all my statements
contained within this application, related papers, and orally during an interview process, as well as a thorough
background check of my personal history by law enforcement agencies. I understand that falsification of data
so given or other derogatory information discovered as a result of this investigation may prevent me from being
hired, or, if hired, may subject me to immediate dismissal. I authorize the Agency to secure information
concerning my experience, releasing all parties from any liabilities arising there from.
If I am employed by the Agency, my employment status shall be that of an at-will employee; therefore, my
employment may be terminated by me or by the Agency at any time. I further understand that such
employment is for no definite period of time and the Agency can change wages, benefits, and conditions of my