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Employment Application

Title of Resume:

Objective:

When Can You Start:

Work Status:

I am authorized to work in this countryI am authorized to work in this country for my present employerI require sponsorship to work in this country

Employment History:

References:

Education:

Affiliations:

Additional Skills:

Additional Information:

Have you ever pleaded guilty or no contest to, or been convicted of a crime?:

YesNo

Type of Empoyment Desired:

Full TimePart TimeTemporarySeasonalEducational Co-op

Contact Information

*First Name:

*Last Name:

*Email Address:

*Day Phone:

Home Phone:

Preferred Contact:

Street Address:

City:

State:

Zip Code:

Comments:

Application Statement:

I certify that I have read, fully understand, and accept all the terms of the following application statement

Do not submit this form until you have read the complete application statement below.

I certify that the information I have provided in order to apply for and secure work with this employer is true, complete and correct. I authorize the employer, its representatives, employees or agents to contact and obtain information from all personal and professional references, employers, public agencies, licensing authorities, and educational institutions and to verify the accuracy of all information provided by me in this application, resume or job interview. 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 manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this application remains current for 30 days only. 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 complete a new application. I also understand that the employer may also require that I complete in writing a hardcopy, paper-based application form.

If I am hired, I understand that the basis for my employment is At-Will, and 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 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 finite 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 language are valid unless they are in writing and signed by the employer's principal or president. 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.

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 being considered for employment on the basis of sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state, or local law. This company does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status. This company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly.

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 my immediate discharge from the employer's service, whenever it is discovered.