Employment Application At People's Place

Employment History
(Account for at least the last five (5) years of employment. Start with most recent. Please complete in full, see resume is not sufficient)
Employer
Address :
Phone Number
Please enter a valid phone number.
From:
Through:
How many hours a week did you work?
Name of Final Supervisor:
Supervisor Phone
Please enter a valid phone number.
Permission to call Employer?

YesNo
Job Title & Brief Summary of Duties:
Reason for Leaving:

Please read the following statement carefully, and add your signature in the space provided.
I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, falsified statements, omission or misrepresentations on this application shall be considered sufficient cause for immediate termination. If I am released for this reason, I will be paid only through the day of release. I authorize the Agency to make an investigation set forth in this application and release the Agency from any liability. I understand that employment at this Agency is “at will”, which means that either I or the Agency can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is considered on that basis. I understand that no supervisor, manager or executive of the Agency, other than the Executive Director, in writing, has any authority to alter the foregoing
Signature*

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Date*

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Date
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People's Place