Application for Employment

This application for employment is good for 6 months. After 6 months, a new application is required. Every applicant will receive consideration without regard to race, color, religion, sex, national origin, age, veteran status, or disability that does not prohibit performance of essential job functions. Application must be completed in full even if attaching a resume.

Personal




General Information




Employment History

Employer 1



Employer 2




Education










Additional Experience or Qualifications




Professional References

Reference 1



Reference 2




Resume

Click or drag a file to this area to upload.



Notification and Agreement

Please read very carefully before signing


In making this application for employment an investigative consumer report may be prepared whereby information is obtained through personal interviews with your neighbors, friends, or other acquaintances. Such an inquiry would include information as to character, general reputation, personal characteristics, and mode of living. You have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.


I authorize you to communicate with persons listed as references, former employers, and any others with whom you desire to check. I agree to hold such persons harmless with respect to any information they may give about me.


I authorize you to communicate with persons listed as references, former employers, and any others with whom you desire to check. I agree to hold such persons harmless with respect to any information they may give about me.


If employed, I agree to engage in no outside activity which would involve a material conflict of interest with, or which could reflect adversely on the Company. I understand this decision is to rest with the Company.


If employed, I agree to hold in strictest confidence any information concerning the Company, its Insureds, its Customers and its Agents which may come to my knowledge.


In consideration of my employment, if I am employed, I agree to conform to the employment policies of the Company, and I understand that my employment and compensation can be terminated, with or without notice, at any time, at the option of either the Company or myself. I understand that no representative of the Company, other than the President, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.


I understand that completion of this Application for Employment does not guarantee that I have been employed by this Company.


I hereby affirm that my answers to these statements and questions are true and correct to the best of my knowledge. I have not knowingly withheld any fact or circumstance that would, if disclosed, affect my application unfavorably.


I understand that any misrepresentation, deception, or false statement made in this Employment Application may result in my not being considered for employment, and if not discovered by the Company until after my becoming employed, is grounds for, and may result in, my immediate termination.

Clear Signature