ACS APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT
DATE:*

MonthDayYear
Date
PERSONAL INFORMATION
Name:*
Middle
Last*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address

Mailing address

Street Address Line 2

CityState

Zip Code
Home Phone:*
Home Phone
Cell Phone:*
Cell Phone
E-mail:*
example@example.com
POSITION DESIRED :*
Available date to start:*

MonthDayYear
Date
Desired pay range :
Are you currently employed?*

YESNO
EDUCATION:

Specialized training

	Name and location	Graduate? - Degree?	Major / Subjects of study
High School:
University
Trade School, etc

Please list your areas of highest proficiency, special skills or other items that may contribute to your abilities in performing the above mentioned position.
Can you submit proof of legal employment authorization and identity?*

YesNo
Have you ever been convicted of a crime in the last 7 years.*

YesNoOther
PREVIOUS EXPERIENCE
Please list beginning from most recent:
Dates employed :

MonthDayYear
Date
Company Name:
Location
Role / Title
Job notes, task performed:
Reason for leaving:
Dates employed :
Company Name:
Location
Role / Title
Job notes, task performed:
Reason for leaving:
Dates employed :

MonthDayYear
Date
Company Name:
Location
Role / Title
Job Notes, task performed:
Reason for leaving :
IMPORTANT
We are glad you are interested in working for ACS, LLC. Please read the following statement carefully before you sign and submit this application. In considering my application for employment, ACS. may verify the information set forth on this application and obtain additional background information relating to my background. I authorize all persons, schools, companies, corporations, credit bureaus, and law enforcement agencies to supply any information concerning my background. I have read and agree to this statement.
Please initial and date here:*
I understand that ACS, LLC. is committed to maintaining an alcohol/ drug free workplace and requires a drug screening test as a part of its selections and hiring practices. I understand that such drug screening will consist of the testing of a urine sample or a medical recognized test designed to detect traceable amounts of a controlled substance in my body. If it is determined my specimen contains a controlled substance or was adulterated or substituted, I will be disqualified from consideration for employment and any offer will be withdrawn. I understand and agree that if I am employed I may be required to submit to alcohol drug testing under certain circumstances during my employment. I have read, understand and agree to this statement.
Please initial and date here:*
I certify that the information on this application is correct and understand that any misrepresentation or omission of any information will result in my disqualification from considering for employment or if employed, my dismissal. I understand that this application is not a contract, offer or promise of employment and that if hired, I will be able to resign at any time for any reason. Likewise, the company can terminate my employment at any time with or without cause, unless otherwise required by law. I have read, understand and agree to this statement.
Please initial and date here:*
I understand that this application is good for sixty (60) days from today's date. If I still desire a position with the company after this application has expired, it will be my responsibility to fill out a new application and file it with the company. Otherwise, the company will not consider me for employment after this application expires.
Please initial and date here:*
I authorize investigation of statements contained in this application. I understand that misrepresentation or commission of facts called for it cause for dismissal, Further, I understand and agree that employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without previous notice. Furthermore, I authorize and agree to a pre-employment drug screening test, which the company may ask me to take prior to my employment with the company.
Please initial and date here:*
Signature*

Clear
Date:

MonthDayYear
Date
Should be Empty: