Employment

Employment

Items in red are required.

Position Applied For
 Salary Desired
 Referral Source (Name)

Personal Information

First Name
 Middle Name
 Last Name
Phone
 Email
Address
 City
 State
 Zip

Education

What is the highest level of education have you completed? If college, what is your degree
List any specialized training
Indicate any foreign languages you can speak, read, and/or write

Employment History

Are you currently employed?

Current Employer (or most recent employer)

Employer Name
 Position
 Employer Phone

  
Address
 City
 State
 Zip
Date of Employment
From (mm/yyyy)      To (mm/yyyy)
 You were employed as:
  
Supervisor
Reason for Leaving

May we contact this employer
Description of duties, responsibilities and equipment operated
  

Previous Employer

Employer Name
 Position
 Employer Phone

  
Address
 City
 State
 Zip
Date of Employment
From (mm/yyyy)      To (mm/yyyy)
 You were employed as:
  
Supervisor
Reason for Leaving

May we contact this employer
Description of duties, responsibilities and equipment operated
  

Check All That Apply

If you are under 18 years of age, can you provide required proof of your eligibility to work?
 Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? Have you ever filed an application with us before? If yes, give date.
/ / (mm/dd/yyyy)
Have you ever been employed with us before? If yes, give date.
/ / (mm/dd/yyyy)
On what date would you be available to work?
/ / (mm/dd/yyyy)
Are you available to work?


What days are you available to work?





Have you been convicted of a felony within the last 7 years?
(Conviction will not necessarily disqualify an applicant from employment.)
If yes, please explain:   

References

Reference ONE Name
 Title
 Phone Number
Reference TWO Name
 Title
 Phone Number
Reference THREE Name
 Title
 Phone Number

Resume

Affirmative Action Survey (Optional)

Government agencies require periodic reports on the sex and ethnicity of applicants. This data is for analysis and affirmative action only. Submission of information is voluntary.

Select from the following, all that apply:

Sex
Race

Applicant's Statement

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and that (The Company) may discharge the Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the President of (The Company).

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also that I am required to abide by all rules and regulations of (The Company). (The Company) is a Smoke-Free/Drug-Free workplace. Smoking is prohibited inside any building, and is permitted outside only before work, after work, and/or during breaks and lunch.

PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT

By clicking here, I understand that any potential offer of employment is contingent upon my satisfactorily passing a pre-employment background check and drug screen and I certify that answers given herein are true and complete to the best of my knowledge.

Authorization for Employment Reference Check

I, the undersigned, an applicant with (The Company) hereinafter called “Employer,” do hereby authorize any person, firm, corporation, or other entity to furnish any information requested by Employer, concerning myself including, but not limited to, my employment, skill and work habits, ability to perform the essential functions of the job for which I have applied, academic records, criminal records, character, and legal history. I further release, discharge and hold harmless Employer, and any party delivering information to Employer pursuant to this authorization, from any liability, claims, charge, cost or causes of action which I or my heirs, executors or assigns may have as a result of the delivery, disclosure, non-disclosure or omission of any information in connection herewith.

I further understand and agree that the information for this reference check may be obtained through interviews with parties having information which pertains to me and my history, and through requests to former employers, law enforcement agencies, academic institutions, credit reporting agencies, financial sources, governmental agencies or any other entitles.

Should I become employed by (The Company), I hereby agreed to submit to periodic checks of my background by Employer at employer’s sole discretion, which may include inquiries to the same magnitude and extent as authorized in this authorization. The timing of the subsequent periodic checks shall be the sole discretion of (The Company). I further agree that if I attempt to withdraw this authorization during my employment with (The Company) said withdrawal should be deemed justification for immediately termination of my employment.

BY CHECKING THIS AUTHORIZATION, I HEREBY ACKNOWLEDGE THAT I FULLY UNDERSTAND AND AGREE TO ALL OF THE TERMS AND CONDITIONS HEREIN STATED AND THAT THIS AUTHORIZATION AND AGREEMENT IS MY FREE ACT AND DEED. FURTHER, I UNDERSTAND THAT NO COMPANY DOCUMENT OR STATEMENT MADE SHOULD BE CONSTRUED AS DIRECT, IMPLIED, OR INFERRED CONTRACTS OF EMPLOYMENT BETWEEN MYSELF AND THIS EMPLOYER, AND THAT IF EMPLOYED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED WITH OR WITHOUT CAUSE AND WITH OUR WITHOUT NOTICE AT ANY TIME, AT THE OPTION OF EITHER ME OR THE EMPLOYER.

 
© Verizon Wireless.
Facebook   Twitter