Employment Application


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	Employment Application
	It is our policy to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental handicap, or veteran status..

Your Contact Information

Your Full Name*

Email*

Street Address*

Phone 1*

City*

State*

Zip Code*

Phone 2

If hired, are you able to present evidence of your legal right to work in this country?

Yes

Employment Information

Desired Position

Other Position (if applicable)*

Desired Location

Date You Can Start*

Desired Salary*

Are you currently employed?*

Yes

If so may we contact your current employer?*

Yes

Have you ever applied to Creditors Interchange before?

Yes

When:

How did you hear about opportunities at Creditors Interchange?

Have you ever been convicted of a felony or misdemeanor (other than traffic violations)?

Yes

Educational Background

High School

Name of School

Address

# of yrs. attended:

Did you graduate?

Yes

College

Name of School

Address

# of yrs. attended:

Did you graduate?

Yes

Other

Name of School

Address

# of yrs. attended:

Did you graduate?

Yes

Subject of Special Study

Special Skills

Activities (civil, athletic, hobbies etc.)

U.S. Military Service

Rank:

Natn'l Guard

Reserves

Previous Employment

List your last 4 employers starting with the most recent:

Employer 1 (most recent)

Address

Title / Position

Reason For Leaving

Start Date

End Date

Salary

Employer 2

Address

Title / Position

Reason For Leaving

Start Date

End Date

Salary

Employer 3

Address

Title / Position

Reason For Leaving

Start Date

End Date

Salary

Employer 4

Address

Title / Position

Reason For Leaving

Start Date

End Date

Salary

Personal References

Give the names of three persons not related to you, whom you have known for at least one(1) year:

Reference 1 (Name)

Phone

Yrs. Acquainted

Business

Address

Reference 2 (Name)

Phone

Yrs. Acquainted

Business

Address

Reference 3 (Name)

Phone

Yrs. Acquainted

Business

Address

I affirm that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. Also understand and agree that the terms and conditions of employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its President, and then only in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.