Application For Employment (Page 2 of 4) in pdf

SKILLS AND QUALIFICATIONS

Summarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying:

________________________________________________________________________________________________________________________

Computer Skills (Check where appropriate. Include software titles and years of experience.)

___ Word Processing____________________________________Years:______

___E-Mail_______________________________ Years:______

___ Spreadsheet________________________________________Years:______

___Internet______________________________ Years:______

___ Presentation________________________________________Years:______

___Other________________________________ Years:______

EDUCATIONAL BACKGROUND

Starting with your most recent school attended, provide the following information:

School (include City/State)

Years Completed

Completed

GPA/Class Rank

Major/Minor

___Diploma ___GED

___Degree_______________

___Certification___________

___Other_________________

___Diploma ___GED

___Degree_______________

___Certification___________

___Other_________________

___Diploma ___GED

___Degree_______________

___Certification___________

___Other_________________

REFERENCES

List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable,

list three schools or personal references who are not related to you.

Name

Title

Relationship

Telephone

Number of Years

to you

Known

APPLICANT STATEMENT

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and

professional), employers, public agencies, licensing authorities and educational institutions and to otherwise 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 employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating

any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for 90 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for

employment,

If I am hired, I understand 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 definite 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 express language are valid unless they are in writing and

signed by the employer’s 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 of America and that federal

immigration laws require me to complete an I-9 Form in this regard.

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 (1) eliminate me from

further consideration for employment, or (2) may result in my immediate discharge from the employer’s service, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Signature of Applicant_________________________________________________________ Date _____/_____/_____