Page 3 - NEW-Missouri-Office

GENESYS Name:

S Y S T E M S I N T E G R A T O R
Employment Consent
I hereby certify that the answers and other information on this application are true and correct. I understand that any
falsification or omission of facts on my part will be justification for GENESYS’ refusal to hire me, or if employed, my
immediate dismissal.

I understand that employment is contingent upon drug testing and other pertinent background checks. I further consent
that GENESYS may terminate my employment based on the results of the drug test and other pertinent background
checks.

I understand that employment at GENESYS is at-will. That means that either GENESYS or I am free to terminate my
employment at anytime and for any reason.

You have my permission to contact any of my previous employers.
I have been provided and have read the following: Equal Employment Opportunity (EEO); Fair Labor Standards Act
(FLSA); Family and Medical Leave Act (FMLA); Employee Polygraph Protection Act (EPPA); Uniformed Services
Employment and Reemployment Rights Act USERRA)

Applicant Signature Date

3210 E 85th St GENESYS
Kansas City, MO 64132
www.GENESYScorp.net Wednesday, December 28, 2016
Phone: (816) 525-7701
Fax: (816) 525-7720