Employment Application
By completing this application, you understand and accept that you are applying for a position as an "At Will" employee. "At Will" employment means that either you or the Company can terminate your employment with or without cause and with or without notice.
~NOTE - All positions are for "On Call" only, no Full-Time or Part-Time positions implied~
Name:
*
First Name
Middle Initial
Last Name
Suffix
Other Names by which you have been known (if any)
First Name
Middle Initial
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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Algeria
American Samoa
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Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
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Bahrain
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Barbados
Belarus
Belgium
Belize
Benin
Bermuda
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Bolivia
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Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Birth Date
*
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Please select a year
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1921
1920
Year
Home Phone
-
Area Code
Phone Number
Mobile Phone
*
-
Area Code
Phone Number
E-mail Address:
*
Emergency Contact
*
Name
Phone
E-Mail
Relatives Currently or Formerly Employed at Company
First Name
Middle Initial
Last Name
First Name
Middle Initial
Last Name
Back
Next
EDUCATION
Start with your curr.
Employment History
Start with your current or most recent employer and work backwards regarding all former employers.
Current or Most Recent Employer:
*
Name of Employer
Home Address
Address
City, State, Zip
City, State, Zip
Last Position Held
Last Position You Held:
Immediate Supervisor
Immediate Supervisor(s)
Phone Number
Phone Number(s)
Date of Employment
Dates of Employment
Most Recent Salary or Hourly Rate
Job Title and Responsiblities
Job Title and Responsibilities
Hours worked per Week
Reason for Leaving
May we Contact this Employer?
*
Please Select
Yes
No
Next Recent Employer:
Name of Employer
Address
Address
City, State, Zip
City, State, Zip
Last Position Held
Last Position You Held:
Immediate Supervisor
Immediate Supervisor(s)
Phone Number
Phone Number(s)
Dates of Employment
Dates of Employment
Most Recent Salary or Hourly Rate
Job Title and Responsibilities
Job Title and Responsibilities
Hours worked per Week
Reason for Leaving
May we Contact this Employer?
Please Select
Yes
No
Next Recent Employer:
Name of Employer
Address
Address
City, State, Zip
City, State, Zip
Last Position Held
Last Position You Held:
Immediate Supervisor
Immediate Supervisor(s)
Phone Number
Phone Number(s)
Date of Employment
Dates of Employment
Most Recent Salary or Hourly Rate
Job Title
Job Title and Responsibilities
Hours worked per Week
Reason for Leaving
May we Contact this Employer?
Please Select
Yes
No
References
Please list two references that are familiar with your work life.
Reference 1
Name:
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Years Known:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Click to edit
Reference 2
Name:
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Years Known:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Back
Next
1. Can you provide proof of eligibility to become employed in the United States?
*
Please Select
Yes
No
If no on #1, are you able to provide such proof which will be required upon employment if you are offered a position?
Please Select
Yes
No
2. If you are under the age of 18, can you provide required proof of your eligibility to work?
*
Please Select
Yes
No, I am over the Age of 18
3. Have you ever filed an application for employment with us before?
*
Please Select
Yes
No
If Yes, set forth dates of your application:
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
4. Are you currently employed?
*
Please Select
Yes
No
If currently employed and you do not wish for us to contact your employer, please set forth the reasons why:
If yes, Explain
5. Are you currently on layoff status and subject to recall?
*
Please Select
Yes
No
6. Do you have adequate transportation to meet travel requirements of the job?
*
Please Select
Yes
No
7. Do you have a current valid drivers license?
*
Please Select
Yes
No
If yes, please state the following:
Issuing State
Expiration Date
8. Are you able and willing to travel for this job if travel is necessary?
*
Please Select
Yes
No
9. Are you aware of any reason that may restrict your ability to perform the essential functions of the job for which you are making application?
*
Please Select
Yes
No
If yes, please explain and describe what accommodations might be necessary:
If Yes, Explain
10. Have you ever been terminated or forced to resign from your employment with any employer?
*
Please Select
Yes
No
If yes, please explain:
If yes, Explain
11. Have you ever been denied a security clearance?
*
Please Select
Yes
No
If yes, please explain including the employer for whom the security clearance was denied, the date on which such security clearance was denied and the reason that such security clearance was denied:
If Yes, Explain
12. Have you ever been convicted of a crime including any driving and/or alcohol related offenses?
*
Please Select
Yes
No
If yes, please explain:
IF yes, Explain
Back
Next
Position Desired ~NOTE - All positions are for "On Call" only, no Full-Time or Part-Time positions implied~
*
Any
Administration
Teaching
Volunteer
GENERAL SKILLS REQUIRED
PDF, PNG, JPG, JPEG are the only accepted file formats for upload
Proficiency Level in the following areas
*
Very Proficient
Proficient
Somewhat Proficient
Not Proficient
Record Keeping
Report / Technical Writing
Basic Computer Skills
General Work Ethic
Leadership Abilities
Safety Awareness
Commitment to Safe Practices
CURRENT First Aid
CURRENT CPR with AED
CURRENT and VALID DRIVER'S LICENSE
*
Proficiency Level in the following areas
*
Very Proficient
Proficient
Somewhat Proficient
Not Proficient
Student Teaching
Training K-12
Digital Art Instruction
School Administration
Communication Skills
Mechanical Aptitude
Problem Solving
Record Keeping
Report / Technical Writing
Basic Computer Skills
General Work Ethic
Leadership Abilities
Safety Awareness
Commitment to Safe Practices
Back
Next
Company Policies
Enter One or All of the Policies into this box
You must accept all Company Policies to proceed with the application process
Accept Policies
By Submitting this application I understand that the Company requires its employees to adhere to the highest standards of business and personal ethics and responsibility. I understand that the Company believes that one method by which such high standards are demonstrated is through the timely meeting of financial obligations. Consequently, I understand and agree that by making application for a position with this company, I am agreeing that my credit worthiness is substantially related to the job for which I am applying or which I hold and that my credit worthiness may be examined by the company. I further understand and agree that this application is not a contract of employment. I understand and agree that the Company adhere to a policy of employment at will which means that either I, or the employer, may terminate my employment at any time, or for any reason, consistent with application of state and federal law. I further understand that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is in a written employment contract naming me and signed by the President of the Company. I understand that to be employed, I must be lawfully authorized to work in the United States and must show the employer documents to prove this. I understand that the Company may investigate my work and personal history and verify the information provided in this application, on related documents or information obtained through other sources and I hereby authorize such investigation. I authorize all individuals, schools, firms and business named in this application or in other documents or interviews, except my current employer if I have so designated in this application, to provide complete and accurate information regarding my relationship with them to the Company. I further release those individuals, schools, firms and business and the Company from any and all liability for damage for providing or requesting such information. I certify under penalty of perjury that all of the information provided in the entire application process including any information provided in addition to this application including, but not limited to, information provided in resumes or interviews is true and correct. I understand that if there is any falsification or omission, this may lead to the Company’s refusal to hire me or a determination, at any time, that my employment should be terminated.
The Company is an Equal Employment Opportunity Employer and considers all applicants without regard to race, color, religion, gender, national origin, age, marital status, veteran’s status, the presence of a mental, physical or sensory disability, sexual orientation, or any other legally protected status. Employment shall be based solely on the needs of the companies and the qualifications of the individuals making application.
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