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APPLICATION FOR EMPLOYMENT
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Applicants are considered for all positions without regard to race, color, religion,
gender, national origin, age, marital or veteran status, medical condition or handicap,
or any other legally protected status.
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Application Form
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Education
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High School
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Undergraduate College/University
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Graduate Professional
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School Name & Location
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Years Completed
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Diploma/Degree Earned & Course of Study
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Describe Course of Study:
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Describe any specialized training, apprenticeship, skills and extra-curricular activities:
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Describe any honors you have received:
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State any additional training (workshops, short courses, and/or certificates)
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List professional, trade, business or civic activities and offices held: (You may
exclude memberships which would reveal race, color, religion, gender, national origin,
age, marital or veteran status, medical condition or handicap, or any other protected
status.)
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Employment Experience
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Start with your present or most recent job. Include any job-related military service
assignments and volunteer activities. You may exclude organizations which indicate
race, color, religion, gender, national origin, age, marital or veteran status,
medical condition or handicap, or any other legally protected status.
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References:
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Applicant’s Statement:
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I certify that all information provided herein is true and complete to the best
of my knowledge.
I authorize investigation of all statements contained in this application for employment,
resume, or job interview as may be necessary in arriving at an employment decision.
I hereby waive any and all rights and claims I may have regarding the employer or
its representatives for using such information in the employment process and all
other persons for furnishing such information.
This application for employment shall be considered active for a period of time
not to exceed (6) months. Any applicant wishing to be considered for employment
beyond this time period should reapply and complete a new application.
I hereby understand and acknowledge that, unless otherwise defined by applicable
law, any employment relationship with this organization is of an “at will” nature,
which means that the Employee may resign at any time and the Employer may discharge
Employee at any time with or without cause. It is further understood that this “at
will” employment relationship may not be changed by any written document or by conduct
unless an authorized executive of this organization specifically acknowledges such
change in writing. This application does not constitute an employment agreement
or contract.
In the event of employment, I understand that false, incomplete or misleading information
provided in my application or interview(s) may result in discharge. I understand,
also, that I am required to abide by all rules and regulations of the employer.
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