List names or employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If Self-employed, give firm name and supply business references.
PLEASE GIVE MONTH AND YEAR.
Click on the "+" below to add more Employer Blocks
List all Names and Addresses of each School attended.
Click on the "+" below to add more Education Levels. Select a new educational level for each new block you add.
PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING
I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from futher consideration for employment and may result in my dismissal if discovered at a later date.
I understand that the employer may request an investigative consumer report from a consumer reporting agency. This report may include information as to my charactor, reputation, personal characteristics and mode of living obtained from interviews with neighbors, friends, former employers, schools and others. I understand I have a right to make a written request within reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature and scope of investigation.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers, andorganizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
I understand that if I am extended and offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre-and/or post- drug screen as a condition of employment, if required.
I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITH OUT CAUSE OR WITHOUT NOTICE.
I have read, understand, and by my signature consent to these statements.