Employment | Current Applications

Current Applications Employment Application

Name:

Address:

How long at present address?

Cell Phone:

Home Phone:

Date:

Type of work/position applying for:

Salary Desired:

How were you referred to Current Applications:

Do you have any friends/relatives who are employed by Current Applications?

Yes

Please specify:

Are you 18 years or older?

Yes

Do you have transportation?

Yes

Are you a U.S. Citizen?

Yes

Are you prevented from lawfully becoming employed in this country because of Visa/Immigration status?

Yes

Proof of Citizenship or immigration status will be required upon employment.

Are you available for:

Full Time

Part Time

Shift Work

Have you ever been convicted of a felony?

Yes

If yes, explain:

List three (3) previous employers, starting with the most current:

1. Company, Address, Contact and Phone:

Date Started and Date Left:

Reason for Leaving, Rate of Pay and Responsibilities:

2. Company, Address, Contact and Phone:

Date Started and Date Left:

Reason for Leaving, Rate of Pay and Responsibilities:

3. Company, Address, Contact and Phone:

Date Started and Date Left:

Reason for Leaving, Rate of Pay and Responsibilities:

May we contact your present employer?

Yes

List three (3) references (do not include relatives):

1. Name, phone and address:

2. Name, phone and address:

3. Name, phone and address:

Education: Name/Location, # of Years Completed, Degree/Diploma

Elementary:

High School:

College:

U.S. Military Service:

Branch of Service, Period of Active Duty (Month and Year) From and To, Rank at Discharge, and Final Discharge Date:

A copy of your DD214 (the long-form version) will be required at time of interview to verify military service details.

Describe duties and any special training:

Please use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying:

Long answer

Applicant's Statement

I understand that Current Applications follows an "employment at will" policy, in that I or Current Applications may terminate my employment at any time, or for any reason. I understand that this application is not a contract of employment. I understand that federal law prohibits the employment of unauthorized aliens; all persons hired must submit satisfactory proof of employment authorization and identity; failure to submit such proof will result in denial of employment.

I understand this application will be active for a one (1) year period; after that time, if I wish to be considered for employment, I must submit a new application.

I understand that Current Applications will thoroughly investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested, and I release them from all liability for damage in providing this information.

I understand that Current Applications is an equal opportunity employer and that prospective employees receive consideration without discrimination because of race, creed, color, sex, age, national origin or handicap.

I understand that as part of my application for employment, I hereby voluntarily submit to both a background records check and credit check to be conducted by Current Applications. I am providing my confidential information to be used only for this background check and credit check. It is also my understanding the information being obtained will not be used in violation of any federal or state equal opportunity law or regulation.

I certify that all the statements herein are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal of employment.

Full Legal Name (please print):

Other names used (alias, maiden, etc):

Signature:

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Date: