Global Orientations

Application for Employment

Personal Information

Date unknown

Name (Last, Middle, First)

Present Address

Permanent Address

Contact Number

Are you 18 years or older

Yes

Are you prevented from lawfully becoming employed in the country because of Visa or immigration status?

Yes

Employment Desired

Position

Date you can start

Salary desired

Are you employed now?

Yes

If so, may be we inquire of your present employer?

Yes

Referred By:

Education

Name and Location

Years attended

Did you graduate?

Subject Studied

High School (GED)

Yes

College

Yes

Other

Yes

General

Subjects of Special Study

Special Skills

Activities (Civic, Athletic, etc.)

U.S. Military or Naval Service

Rank

Present Membership in National Guard or Reserves

Former Employers

Employer 1

Name of Employer

Dates Employed

Address

Salary or Hourly Wage

Position

Reason for Leaving

Employer 2

Name of Employer

Dates Employed

Address

Salary or Hourly Wage

Position

Reason for Leaving

Employer 3

Name of Employer

Dates Employed

Address

Salary or Hourly Wage

Position

Reason for Leaving

References

Give the names of 3 people not related to you

Reference 1

Name

Address

Business

Phone Number

Years Acquainted

Reference 2

Name

Address

Business

Phone Number

Years Acquainted

Reference 3

Name

Address

Business

Phone Number

Years Acquainted

Electronic Signature

By submitting your electronic signature with this application, you are agreeing to the following:

"I certify 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, with or without cause, and with or without notice, at any time, at either my or the company‚Äôs option. I also understand and agree that the terms and conditions of my 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 only when 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."

I Agree

Yes

Signature