Project South Application for Employment

Project South Application for Employment

PROJECT SOUTH is an equal opportunity employer. PROJECT SOUTH does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mentaldisability, military status or unfavorable discharge from military service or any other characteristic protected by law. Each question should be answered completely and accurately.
Personal Information

Incomplete information could disqualify you from further consideration. Please complete all fields.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
example@example.com
Home Phone #*

Area CodePhone Number
Mobile Phone #

Area CodePhone Number
Are you eligible to work in the United States?*

YESNO
Are you at least 18 years or older? (If no, you may be required to provide authorization to work.)*

YESNO
Have you ever been terminated from employment or asked to resign by an employer?*

YESNO
If yes, please provide company names and details
Can you work overtime, including weekends?*

YESNO
Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?*

YESNO
Employment Desired
Date available for work*

MonthDayYear
Hourly rate/Salary desired*
Position(s) applying for*
Are you currently employed?*

YESNO
Referral source*
Upload your cover letter, click Choose File

Upload a File

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Upload your resume, click Choose File*

Upload a File

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EDUCATION
Highest level of education completed:*

Please complete the appropriate sections

	Name & Location of School	Number of Years Attended	Did You Graduate?	Degree or Certification
GED / High School
Trade School
College
Graduate

WORK HISTORY

Please list your four most recent employers, list the most recent first
1. Employer
Employer's Name (Most current)*
Address & location of business*
Your title*
May we contact this employer?*

YESNO
Supervisor's name*
First and Last Name
Phone number*

Area CodePhone Number
Start date*

MonthDayYear
End date

MonthDayYear
Wages START:*
Salary or Hourly*
Wages END:*
Salary or Hourly*
Work performed:*
Reason for leaving*
2. Employer
Employer's Name (Second most recent)*
Address & location of business*
Your title*
May we contact this employer?*

YESNO
Supervisor's name*
First and Last Name
Phone number*

Area CodePhone Number
Start date*

MonthDayYear
End date

MonthDayYear
Wages START:*
Salary or Hourly*
Wages END:*
Salary or Hourly*
Work performed:*
Reason for leaving*
3. Employer
Employer's Name (Third most recent)
Address & location of business
Your title
May we contact this employer?

YESNO
Supervisor's name
First and Last Name
Phone number

Area CodePhone Number
Start date

MonthDayYear
End date

MonthDayYear
Wages START:
Salary or Hourly
Wages END:
Salary or Hourly
Work performed:
Reason for leaving
4. Employer
Employer's Name (Fourth most recent)
Address & location of business
Your title
May we contact this employer?

YESNO
Supervisor's name
First and Last Name
Phone number

Area CodePhone Number
Start date

MonthDayYear
End date

MonthDayYear
Wages START:
Salary or Hourly
Wages END:
Salary or Hourly
Work performed:
Reason for leaving
ADDITIONAL INFORMATION
List any additional information you would like us to consider:
REFERENCES

Give the names of two Professional references and one Personal reference not related to you, whom you have known at least three (3) years
1. Full Name*

First NameLast Name
Company*
Best phone number to reach them*

Area CodePhone Number
Years acquainted*
Relationship*
2. Full Name*

First NameLast Name
Company*
Best phone number to reach them*

Area CodePhone Number
Years acquainted*
Relationship*
3. Full Name*

First NameLast Name
Company*
Best phone number to reach them*

Area CodePhone Number
Years acquainted*
Relationship*
Please read carefully before signing

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for PROJECT SOUTH to hire me. If I am hired, I understand that either PROJECT SOUTH or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of PROJECT SOUTH has the authority to make any assurance to the contrary.

I attest with my signature below that I have given PROJECT SOUTH true and complete information on this application. No requested information has been concealed.

I authorize PROJECT SOUTH to contact references provided for employment reference checks. If any
information I have provided is untrue, or if I have concealed material information, I understand
that this will constitute cause for the denial of employment or immediate dismissal.
By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree
Type signature*
Date*

MonthDayYear
THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE ABOVE.
Please upload your resume here*

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Please upload your cover letter here*

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Should be Empty:

Personal Information

Employment Desired