December 2023

Pursuant to the requirements of Washington State law RCW 43.43.834, we may ask you to complete an Applicant Disclosure Statement. Information obtained from this disclosure statement or from the background inquiries, will not necessarily preclude you from being offered a job but will be considered in determining your character, suitability and competence to perform in the position applied for and may result in denial of position unless precluded by regulations. If your application is selected to move forward in our review process, you will then be asked to complete and sign an Applicant Disclosure Statement pursuant to RCW 43.43.834 (2) (a) in which you will be asked to disclose whether you have been convicted of a crime or had an administrative finding made against you. A copy of the report is available to you upon your request. I declare under the penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. I understand that misrepresentation or falsification of statements made in this application may result in immediate dismissal. I further understand that, if hired, my employment is not for any specific period or duration and is terminable at-will by the employer or me at any time with or without cause or notice. I understand this application is not a guarantee of or contract for employment. authorize the release of all high school, college and other educational records pertaining to my attendance, course work and other school activities. I further consent to the disclosure of any and all information about me contained in private and government files relevant to this application for employment or relating to my present and former employment history, and I request all former listed employers and federal, state and local government agencies to supply said information to you in your request. You are also authorized to make any investigations of my background, fingerprints, personal history, and financial and credit record through any investigative or credit agencies or bureaus of your choice.

To my former employers named above, please furnish TRANSITIONS with personal information requested by TRANSITIONS. I release you, my former employers, from liability that may arise as a result of you providing such information to TRANSITIONS. Upon written request, I am entitled to receive written disclosure of the nature and scope of the investigation requested. This authorization and consent shall be valid in original, fax or copy form. I further authorize ongoing procurement of the above mentioned reports at any time during my employment (or contract). I understand that my employment shall by contingent upon proof of identity and verification of eligibility for employment in the United States in accordance with the Immigration Reform and Control Act of 1986. Such satisfactory proof of employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc) must be presented within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination

Transitions New Leaf program receives $6,000 grant from Umpqua Bank Charitable Foundation

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