Employee Applicant Profile

Employee Applicant Profile

Personal Information

Are you legally authorized to work in the country of employment? Yes No

Position Information

Desired Start Date:

Full-time Part-time Temporary/Contract

Employment History

Employer 1

Dates Employed: From To

Employer 2

Dates Employed: From To

Education

Graduation Date:

Professional References

Please provide three professional references who can speak to your work performance.

Reference 1

Reference 2

Reference 3

Legal Disclosures and Authorizations

At-Will Employment: If hired, I understand that employment is for no definite period and may be terminated by either the Company or me at any time, with or without cause, and with or without prior notice, unless a written agreement states otherwise and is signed by an authorized representative of the Company.

Equal Opportunity: The Company is an equal opportunity employer. Decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or any other characteristic protected by law.

Authorization to Verify: I authorize the Company and its agents to contact all references, former employers, schools, and other persons or entities to obtain information regarding my employment, education, performance and qualifications. I authorize the release of such information and release those parties from any liability for providing it.
I authorize verification and inquiries as described above.

Background Checks: As permitted by law and to the extent job-related, the Company may obtain consumer reports, criminal history, driving records, credit reports and other investigative reports. I understand any offer of employment may be conditioned on the results of those checks and on my continued compliance with Company policy.
I authorize background checks as described above.

Criminal Convictions: Have you ever been convicted of a felony or misdemeanor that has not been annulled, expunged, sealed, or otherwise cleared? Yes No

Applicant Certification

I certify that all information provided in this application and any attached documentation is true, complete and correct to the best of my knowledge. I understand that any willful misrepresentation, falsification, omission or failure to disclose requested information may result in disqualification from employment or, if discovered after hire, termination for cause.

I understand that submission of this application does not constitute an offer of employment and that the Company reserves the right to accept or reject applications in its sole discretion. I acknowledge that I have read and understood the At-Will Employment and Equal Opportunity statements above.

By signing below I acknowledge and consent to the statements, authorizations and acknowledgements contained in this Employee Applicant Profile.

Sign Now