Have you ever been employed with PPLA before?✱

Will you travel if job requires it?✱

Are you available to work on Saturdays if required of the position?✱

How did you hear about this position? (Please select the appropriate source):✱

Are you currently employed by another Planned Parenthood or have you been in the past?✱

Are you legally eligible for employment in this country?✱

I certify that all of the information that I have provided to apply for and secure work with this employer is true, complete and correct. I understand that if I am extended an offer of employment, the offer will be contingent on the successful completion of a background check, employment references and validation of required licensure / education. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state and federal law. If I am hired, I understand that this employment is at-will and I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the CEO. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard. PPLA will consider qualified applicants with a criminal history pursuant to the California Fair Chance Act. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if PPLA is concerned about conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. PPLA does not tolerate unlawful discrimination in its employment practices. No question on the application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of the applicant’s sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state and local law. PPLA likewise does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state and local law. PPLA is committed to the full inclusion of all qualified individuals. As part of this commitment, PPLA will ensure that persons with disabilities are provided reasonable accommodations. If you require reasonable accommodation to complete a job application, a job interview or to otherwise participate in the hiring process, please contact the PPLA Recruitment Department at PPLA-Recruitment@pp-la.org. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in disciplinary action including up to separation of employment, whenever it is discovered. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT. I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement. Do you agree?✱