Turtle Top Employment Application

Application for Employment

We are an Equal Opportunity Employer: Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap, veteran status or any other protected status required by law.
Position Desired:*
Schedule Desired:*

Full-TimePart-Time
Are you under the age of 18?*

NoYes

Your Information
Name*

First Name Last Name
Email*
example@example.com
Home Phone Number
Please enter a valid phone number.
Mobile Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How long have you lived at this address?*
Previous Address:*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How long did you live at this address?*
Applicant’s Statement

I, First Name Last Name , understand that if IPC hires me, my employment will be for no definite period, regardless of the period of payment of my wages. I also understand that I have the right to terminate my employment at any time with or without notice to IPC, and IPC has the same right to terminate my employment at any time with or without notice to me. No one other than the president of IPC has the authority to modify this relationship or make any agreement to the contrary. Any such modification or agreement must be in writing and signed by IPC’s president.

I authorize IPC to investigate my driving record, my criminal record, and my credit history, and I understand that an investigative consumer report may be prepared whereby information is obtained through personal interviews with neighbors, friends, and others with whom I am acquainted. This inquiry would include information as to my character, general reputation, personal characteristics, and mode of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional information about the nature and scope of this investigation.

I grant IPC authority to contact my previous employers and I authorize those employers to disclose to IPC all records and other information pertinent to my employment with them. I also authorize IPC to provide truthful information concerning my employment with IPC to my future prospective employers and I agree to hold IPC harmless for providing such information. I certify that all of the information that I provided on this application and in any interviews will be true and accurate. I understand that if I am employed and any such information is later found to be false or misleading in any respect, I may be immediately dismissed.

I, {name}, certify that I have read and understand the above statement.

Date* Signature*

Have you worked for IPC or any of its subsidiaries before?*

YesNo
Location:  IPC/ Subsidiary Location
Start Date: Start Date   End Date:    Date
Position:   Position
Do you have any friends or relatives working here?*

YesNo
Name:   Name   Relationship:   Relationship
Name:   Name    Relationship:   Relationship
Name:   Name   Relationship:   Relationship
Do you have reliable transportation?*

YesNo
Are you able to perform the essential functions of the job of which you are applying with or without accommodation?*

YesNo
Please explain:

Record of Previous Employment
Current or Most Recent Employer
Company Name*
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date:   *   Year*

End Date:      *   Year*
Starting Pay: $Amount per
Final Pay: $Amount per
Position Held*
Supervisor*

First Name Last Name
Supervisor's Title*
Reason for Leaving*
May we contact this employer?*

YesNo
Why not?
Add Another Employer?*

YesNo

Previous Employer 2
Company Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date: Year
End Date: Year
Starting Pay: $Amount per
Final Pay: $Amount per
Position Held
Supervisor

First Name Last Name
Supervisor's Title
Reason for Leaving
Add Another Employer?

YesNo

Previous Employer 3
Company Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date:      Year
End Date:      Year
Starting Pay: $IPC/ Subsidiary Location per
Final Pay: $Name per
Position Held
Supervisor

First Name Last Name
Supervisor's Title
Reason for Leaving
Add Another Employer?

YesNo

Previous Employer 4
Company Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date:      Year
End Date:
Year
Starting Pay: $IPC/ Subsidiary Location per
Final Pay: $Name per
Position Held
Supervisor

First Name Last Name
Supervisor's Title
Reason for Leaving
Add Another Employer?

YesNo

Previous Employer 5
Company Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date:      Year
End Date:         Year
Starting Pay: $Amount per
Final Pay: $Amount per
Position Held
Supervisor

First Name Last Name
Supervisor's Title
Reason for Leaving

Have you ever been terminated or asked to resign from any job?*

YesNo
Please explain the circumstances
Explain fully any gaps in your employment history*
Please tell us about any actual experience that you have that you feel is relevant to the position for which you are applying for:*

Education

Education*

	School Name	Years Completed	Diploma/Degree	Course of Study or Major	Specific Training, Skills, or Experience
High School
College/University
Graduate/Professional
Trade or Correspondance
Other

Personal References

List persons who know you well (other than relatives and previous employers)

Personal References*

	Name	Occupation	Address	Phone	Years Known
1
2
3
4

Upload Resume

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Cancelof
Although Independent Protection Company may keep this application on file indefinitely, this application will be considered current and active for only thirty (30) days. If you wish to be considered for employment after that time, you must re-submit your application for employment.
I, {name}, certify that all of the information that I have provided on this application is true and accurate.

Date* Signature*
Should be Empty:

Application for Employment

Your Information

Record of Previous Employment

Current or Most Recent Employer

Previous Employer 2

Previous Employer 3

Previous Employer 4

Previous Employer 5

Education

Personal References