Employment Application

Name *
Address *
Home Phone
Home Phone
Cell Phone *
Cell Phone
Will you Accept: *
Name Location Graduation? Subjects Studied Degree?
List any special training and hobbies that would help you qualify for the position for which you are applying.
Speak, Read, Write
Employment History 1: Phone *
Employment History 1: Phone
Employment History 2: Phone
Employment History 2: Phone
Employment History 3: Phone
Employment History 3: Phone
Reference 1: Phone *
Reference 1: Phone
Reference 2: Phone *
Reference 2: Phone
Reference 3: Phone *
Reference 3: Phone
The company may request consumer reports or investigative consumer reports in connection with your application for employment or during the course of your employment (if any), with the company. Any information contained in such reports may be taken into consideration in evaluating your suitability for employment, promotion, reassignment or retention as an employee. Such reports, if obtained, will be prepared by a consumer reporting agency and may contain information concerning your credit standing or worthiness, character, general reputation, personal characteristics, or mode of living. The types of reports that may be requested, include, but are not limited to, credit reports, criminal records checks, court records checks, and/or summaries of educational and employment records and histories. The information contained in such reports may be obtained from public record sources or through personal interviews with your neighbors, friends, associates, current or former employers, or other personal acquaintances. I certify that the information contained in this application is true and correct and complete to the best of my knowledge and belief. I understand that any false statement, omission or misrepresentation of facts in connection with this application can be cause for rejection of my application, or if I am employed, for my dismissal from employment. I also understand that I am required to abide by all rules and regulations of the Employer. I hereby understand and acknowledge that if I am employed, my employment relationship with the Employer is of an "at-will" nature, which means that I may resign at any time and the Employer may discharge me at any time, with or without cause. It is further understood that this "at-will" employment relationship may not be changed by any statement or conduct of any person, unless such change is specifically acknowledged in writing, signed by the President/CPO of the Employer. I acknowledge that no other promises, agreements or representations have been made contrary to this "at-will" employment agreement, and that this agreement, as acknowledged by my signature below, is the full and complete agreement governing the Employer's and my rights and obligations concerning termination of my employment.