HR IT Support Specialist Form

HR IT Support Specialist Form

Personal Information

Full legal name:

Phone:    Email:

Date of birth (optional):

Position Information

Position applying for:

Desired start date:    Employment type: Full-time Part-time Contract

Willing to work rotating shifts or on-call: Yes    Willing to relocate: Yes

Employment History (most recent first)

Employer 1

Job title:    Start date:    End date:

Employer 2

Job title:    Start date:    End date:

Education

Graduation or completion date:

Professional References

Reference 1

Reference 2

Reference 3

Technical Skills & Competencies

Please indicate experience (check all that apply):

Troubleshooting & desktop support   Windows OS   MacOS   Linux   TCP/IP & networking fundamentals

Active Directory / Azure AD   ITSM / ticketing systems   Hardware repair & replacement   Basic scripting (PowerShell, Bash)

Legal Disclosures and Authorizations

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

Equal Employment Opportunity: The company provides equal employment opportunity to all applicants and employees and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic. Reasonable accommodations will be considered where appropriate.

Background and Reference Checks: I authorize the company to verify the information provided on this form, to contact listed references and previous employers, and to obtain consumer and/or investigative background report(s) that include, but are not limited to, credit history, criminal history, driving record, and education verification as permitted by law. I further authorize any persons, schools, current or former employers, and organizations named in this application to provide relevant information and release them from liability for providing such information.

Criminal convictions: Have you ever been convicted of a criminal offense other than a minor traffic violation? No Yes

I authorize contact with my previous employers for the purpose of obtaining reference information and employment verification: Yes

Applicant Certification and Acknowledgment

I certify that all information provided on this form and in any accompanying documents is true and complete to the best of my knowledge. I understand that any misrepresentation, falsification, or omission of material facts may be grounds for denial of employment or immediate termination of employment, if discovered at a later date. I understand that submission of this form does not create an employment contract, and that if employed my status may be at-will as stated above unless otherwise agreed in writing by an authorized representative.

By signing below, I authorize the company to conduct any background, employment, education, and reference checks as required for the position applied for and release all parties from any liability for furnishing such information. I acknowledge receipt of and consent to the background and disclosure statements above.

I certify under penalty of perjury that the foregoing is true and correct.

Applicant initials (type full legal initials):

Sign Now