*A MOTOR VEHICLE RECORDS CHECK WILL BE PERFORMED. A CLEAR DRIVING RECORD IS A CONDITION OF EMPLOYMENT.
*THE AGE DISCRIMINATION IN EMPLOYMENT ACT OF 1967 PROHIBITS DISCRIMINATION ON THE BASIS OF AGE WITH RESPECT TO INDIVIDUALS WHO ARE AT LEAST 40, BUT LESS THAN
70 YEARS OF AGE.
**YOU WILL NOT BE DENIED EMPLOYMENT SOLELY BECAUSE OF A CONVICTION RECORD, UNLESS THE OFFENSE IS RELATED TO THE JOB FOR WHICH YOU HAVE APPLIED.
EMPLOYMENT DESIRED:
EDUCATION:
GENERAL:
FORMER EMPLOYERS: (LIST BELOW THREE EMPLOYERS STARTING WITH THE LAST ONE FIRST).
REFERENCES: GIVE THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.
PHYSICAL RECORD:
IN CASE OF EMERGENCY NOTIFY
SKILLS:
PLEASE DESCRIBE ANY SKILLS YOU HAVE IN THE FOLLOWING AREAS:
COMPUTER/FOREIGN LANGUAGES SPOKEN/ OTHER
“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED
STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.
I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS
EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE ALL PARTIES FROM LIABILITY FOR ANY DAMAGE THAT MY RESULT
FROM FURNISHING SAME TO YOU.
I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NOT DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, MAY BE
TERMINATED AT ANY TIME WITHOUT PRIOR NOTICE.”
