Application for Employment
Thank you for your interest in applying for a position with The Nemasket Group, Inc. Requirements for employment include: Valid Driver’s License, Applicant must be 18 years of age & have a High School Diploma or Equivalent. Upon accepted offer of employment, The Nemasket Group, Inc. will conduct a MA CORI, DPPC Abuser Registry & Identigo Fingerprint background checks. If you require additional assistance, please contact the Human Resource Director at 508-999-4436x127. Please complete the following application in its entirety.
Date:
Name: (Last, First, Middle)
Cell Phone:
Home Phone:
Please enter a valid phone number.
Email Address:
Position(s) Applying For:
Hours Desired:
Full-Time
Part-Time
Overnights
Other
Salary Desired:
When are you available to begin employment?:
-
Month
-
Day
Year
Date
Have you ever applied for employment with our organization?
Yes
No
If yes, when, & what method?
Work Experience
Please list your last three employers, beginning with your most recent employer. You may also include military service, internships or volunteer positions.
1. Employer Name:
Employer Address:
Dates of Employment (Start & End Date):
Position:
Supervisor(s):
Reason for Leaving:
2. Employer Name:
Employer Address:
Dates of Employment (Start & End Date):
Position:
Supervisor(s):
Reason for Leaving:
3. Employer Name:
Employer Address:
Dates of Employment (Start & End Date):
Position:
Supervisor(s):
Reason for Leaving:
Educational Background:
High School (Name & Location):
Select Highest Grade Completed:
9
10
11
12
GED
Major Area of Study (If Applicable):
College (Name & Location):
Select Highest Grade Completed (If Applicable):
1
2
3
4
Major Area of Study:
Trade or Business School (Name & Location):
Major Area of Study:
Graduate School (Name & Location):
Major Area of Study:
Please list any specialized skills you may have.
Certifications/Trainings:
1. Certification Name & Expiration Date:
2.
3.
4.
Upload any Certifications here if applicable:
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References
1 Personal or Professional, 1 Current Supervisor, 1 Past Supervisor
1. Name:
Phone Number
Please enter a valid phone number.
2. Name:
Phone Number
Please enter a valid phone number.
3. Name:
Phone Number
Please enter a valid phone number.
Applicant Certification – Please Read Carefully
I understand that this application is not a contract, offer or promise of employment. I acknowledge that employment with the organization is on an employment at will basis. This means that my employment with the company can be terminated at any time, with or without case and acceptance of employment is not a contract of employment for any specified time. Similarly I am free to terminate my employment with the company at any time for any reason. I further understand that I am responsible for being familiar with the Organization’s policies, procedures and regulations and I understand that the company has complete discretion to modify its policies, procedures and practices at any time, to the extent permitted by federal, state and local law, except that it will not modify its policy of employment at will. By my continued employment with the organization, I consent to such changes. I certify that the above information is correct and accurate to the best of my knowledge. I understand that any falsification, misrepresentation or mission of information on this form or relating to my application of employment may result in my denial of employment, or if employed, my immediate dismissal. I hereby authorize the organization or its agents to confirm all statement contained in this application and/or resume to the extent permitted by federal, state or local law and I agree to complete any requisite authorization forms. I release all parties from any liability arising out of this provision and use of such information.
Signature
Date
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Month
-
Day
Year
Date
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