Please start with your most recent employment. Please include: Company Name, Dates Employed, Start & Final Job Title(s), Immediate Supervisor Name & Telephone, Description of job duties, & reason why you left. If you attached a resume with employment history included, there is no need to complete this portion.
Please include the school name, city & state of school, number of years completed, GPA, Major/Minor & what was completed (Diploma, GED, Degree, or Certification).
Please include the name, telephone number, email address, number of years known & relationship to you.
Please include the name, telephone number, email address, number of years known & relationship to you.
Please include the name, telephone number, email address, number of years known & relationship to you.
Exclude memberships that would reveal race, color, religion, sex, national origin, genetic information, citizenship, age, mental/physical disabilities, veteran/reserve or any other protected status.
Exclude memberships that would reveal race, color, religion, sex, national origin, genetic information, citizenship, age, mental/physical disabilities, veteran/reserve or any other protected status.
I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.
I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manor, in the employment process and all other persons, corporations or organizations for furnishing such information about me.
I understand that this employer does not unlawfully discriminately in employment and no question on this application is used for the purpose of limiting or elimination any application from consideration for employment on any basis prohibited by applicable local, state or federal law.
I understand this application remains current for only 30 days. AT the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.
If I am hired, I understand that 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 without cause and with or without prior notice, except as may be required by law.
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 the regard.
This company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration of employment on the basis of his or her sex, race, color, religion, national origin, genetic information, citizenship, age, disability or any other protected status under applicable federal, state, or local law. This company likewise does not tolerate harassment based on sex, race, color, religion, national origin, genetic information, citizenship, age, disability or any other protected status. Examples of prohibited harassment include, but are not limited to, unwelcome physical contact, offensive gestures, unwelcome comments, jokes, epithets, threats, insults, name-calling, negative stereotyping, possession of display of derogatory pictures or other graphic materials, and any other words or conduct that demean, stigmatize, intimidate, or single out a person because of his/her membership in a protected category. Harassment of our employees is strictly prohibited, whether committed by a manager, coworker, subordinate, or non-employee (such as vendor or customer). The company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly.
I understand that an information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to 1) eliminate me from further consideration for employment, or 2) may result in my immediate discharge from the employer's service, whenever it is discovered.
