AXIOM DIVISION 7 EMPLOYMENT APPLICATION

Axiom Division 7 Application for Employment

Axiom Division 7 is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race. color. religion. sex. sexual orientation, national origin, age, disability or any other basis prohibited by federal, state or local law. We assure you that your opportunity for employment with Axiom Division 7 depends solely on your qualifications.
Last Name
First Name
Middle Name
Date of Birth

MonthDayYear
Date
Street Address
City
State
Zip Code
Telephone
Format: (000) 000-0000.
Last 4 Digits of Your Social Security Number
Are you at least 18 years old?
Email Address
example@example.com
Position or type of work applying for
Are you seeking full time or part time work?
Please indicate the approximate monthly salary desired.
Who referred you to the company?
EDUCATION
Name Of High School
High School Location
Years Completed
Did you Graduate
Name Of College
College Location
Years Completed
Major or Degree
Name Of Other School
Other School Location
Years Completed
Major or Degree
Personal Data
Have you ever been convicted of a crime, other than a minor traffic offense, for which the conviction or prison release (whichever is more recent) is within ten years of the date of this application? Answering yes does not constitute an automatic rejection for employment. Date of the offense and nature of violation will be considered.
If yes, please explain.
Do you have a valid Driver's license?
Driver's License Number
State of Issue
Will Visa or immigration status prevent lawful employment?
Have you ever been in the armed forces?
Are you now a member of the National Guard?
Specialty
Date Entered

MonthDayYear
Date
Discharge Date

MonthDayYear
Date
Employment Record (Please begin with last position held or present position if currently employed).
May we contact your present employer?
Name Of Most Recent Employer
Employer Address, City, State, and Zip Code
Name of last supervisor
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Starting Wage
Ending Wage
Final Job Title
Specific Reason For Leaving
Are You Eligible for Rehire?
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name Of Employer #2
Employer Address, City, State, and Zip Code
Name of last supervisor
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Starting Wage
Ending Wage
Final Job Title
Specific Reason For Leaving
Are You Eligible for Rehire?
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Employer #3
Name Of Employer
Employer Address, City, State, and Zip Code
Name of last supervisor
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Starting Wage
Ending Wage
Final Job Title
Reason for leaving (be specific)
Are You Eligible for Rehire?
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Personal References

Please list three references other than relatives or previous employers.
Reference 1 Name
Reference 1 Employer
Reference 1 Position
Reference 1 Address
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Name
Reference 2 Employer
Reference 2 Position
Reference 2 Address
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 Name
Reference 3 Employer
Reference 3 Position
Reference 3 Address
Reference 3 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)

I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Axiom Division 7 creates an actual or implied contract of employment. I understand that, if I accept employment with Axiom Division 7, it will be on an at-will basis. This means that either Axiom Division 7 or I have the right to terminate the employment relationship at any time, for any reason. with or without cause. I agree to submit to drug and alcohol testing. if requested by Axiom Division 7. I release Axiom Division 7 and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing. I authorize Axiom Division 7 to investigate information concerning my education, employment experiences and all other aspects of my background relevant to my proposed employment. I release Axiom Division 7 and its employees from all liability arising from such investigation.
Signature of applicant
Date

MonthDayYear
Date
Should be Empty: