OGCMA Employment Application

Part II: Education
Education

Other
Name of High School
High School Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Highest High School Grade Completed or Year Graduated
High School Years Attended
Name of College or University
College or University Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
College Years Attended
Graduation Date -or- Highest College Level Completed -or- Other Completed
Describe other education completed

Part III: Experience
Current / Most Recent Employer
Current / Recent Company Name
Current / Recent Company Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current / Recent Company Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Current / Recent Position Held
Current / Recent Supervisor's Name

PrefixFirst NameLast Name
Current / Recent Supervisor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current / Recent Employment Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current / Recent Employment End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason for Leaving Current / Recent Employment
Current / Recent Salary Earned
May We Contact Your Current / Recent Employer?
Previous Employer

Who did you work for previous to your current / most recent employer?
Previous Company Name
Previous Company Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Previous Company Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Position Held at Previous Company
Previous Supervisor's Name

PrefixFirst NameLast Name
Previous Supervisor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Start Date at Previous Employer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Ending Date at Previous Employer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Employment - Reason for Leaving
Salary Earned at Previous Employment
May We Contact Your Previous Employer?
References

Provide the names of three persons not related to you, whom you have known at least one year:
First reference name, phone number, relationship:
Second reference name, phone number, relationship:
Third reference name, phone number, relationship:
Other Experience / Qualifications:
Please list any current certifications, special qualifications (including CPR, First Aid, Musical Abilities, etc.).
Please list any applicable activities: Civic, Athletic, etc.

Part IV: Disclaimer and Signature
Disclaimer

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS CALLED FOR IS A CAUSE FOR DISMISSAL. FURTHER, I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME, WITHOUT ANY PREVIOUS NOTICE.

I UNDERSTAND THAT ALL EMPLOYEES ARE EMPLOYED AT-WILL AND ARE SUBJECT TO TERMINATION AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.

IT IS THE POLICY OF THE OGCMA TO PROVIDE EQUAL OPPORTUNITY IN EMPLOYMENT TO ALL EMPLOYEES AND APPLICANTS FOR EMPLOYMENT. NO PERSON WILL BE DISCRIMINATED AGAINST IN EMPLOYMENT BECAUSE OF RACE, COLOR, SEX, AGE, NATIONAL ORIGIN, DISABILITY, MILITARY STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL OR STATE LAWS.
Signature
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

OGCMA Employment Application

Part I: Applicant Information

Part II: Education

Part III: Experience

Current / Most Recent Employer

Previous Employer

References

Other Experience / Qualifications:

Part IV: Disclaimer and Signature

Disclaimer