Application for Employment
Gillco LLC is an Equal Opportunity Educational Institution and EEO/Affirmative Action Employer committed to excellence through diversity. Employment offers are made on the basis of qualifications, and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.
PLEASE TYPE OR PRINT. Complete the entire application. You may attach a resume, but you must still complete all questions; or your application will be deemed incomplete and may not be considered. Please fill out each box (don't just indicate "See Resume.") Applications with missing or invalid job numbers will not be considered for any position.
Position Applying For:
Name (Last, First, Middle):
First Name
Last Name
Other names under which you have attended school or been employed:
Street Address:
City, State & Zip:
Home Phone:
Format: (000) 000-0000.
Work Phone:
Format: (000) 000-0000.
Other Phone:
Format: (000) 000-0000.
Are you eligible to work in the United States?
Yes
No
Are you 18 years of age or older?
Yes
No
If NO, what is your current age?
Are you currently employed at (company)?
Yes
No
If YES, what is your current job title & department?
Have you ever been employed by (company)?
Yes
No
If YES, dates of employment & reason for leaving:
Are you related to any current (company employee)?
Yes
No
If YES, their name & their relationship to you?
If required for position, do you have a valid driver's license?
Yes
No
If YES, State of issuance, license #, and expiration date:
How did you learn about this employment opportunity at ? Check all that apply:
Ad in newspaper
Job Bulletin (Posting) /Walk-in Website
Dept. of Labor
Ad in magazine
Referral by employee
Other
EDUCATION
EDUCATION
Rows
City/State
Did you graduate?
If No, # of years left to graduate
If Yes, date of Graduation
Degree received
Major
High School:
GED:
Other School:
College:
College:
College:
Other credentials/licenses/professional affiliations, etc., which are relevant to the job(s) for which you are applying.
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SKILLS: Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)
WORK EXPERIENCE-Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT complete this information with the notation "See Resume." PLEASE NOTE: Gillco LLC reserves the right to contact all current and former employers for reference information.
Dates Employed (most recent position) From:
To
Full time
Part-time
Title:
If part-time, # hrs./wk:
Starting Salary:
Organization Name and Address:
Final Salary:
Supervisor's Name, Title and Phone #:
Other Reference Name, Title and Phone #:
At any time
Only if I am a finalist candidate
Primary duties:
Reason for Leaving:
Dates Employed (most recent position) From:
To
Full time
Part-time
Title:
If part-time, # hrs./wk:
Starting Salary:
Organization Name and Address:
Final Salary:
Supervisor's Name, Title and Phone #:
Other Reference Name, Title and Phone #:
At any time
Only if I am a finalist candidate
Primary duties:
Reason for Leaving:
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PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify that the information provided in this application and all supporting documents is true, accurate, and complete to the best of my knowledge. I understand and agree that failure to fully complete this form, or any misrepresentation or omission of facts, may result in disqualification from consideration for employment or termination of employment if discovered at a later date.
I authorize Gillco LLC to investigate, without liability, all statements contained in this application and any supporting materials. I further authorize my references and former employers, without liability, to respond fully to any inquiries related to my application for employment. If requested, I agree to submit to a physical examination, criminal background check, credit investigation, and/or screening for illegal substances upon receipt of a conditional offer of employment. I understand that this document does not constitute an offer of employment, and that any offer of employment, if made, does not create a contract for guaranteed or continued employment. I understand that employment with Gillco LLC is at-will, and that either party may terminate the employment relationship at any time, with or without cause or notice, except as prohibited by law. If employed, I understand that I will be required to provide proof of eligibility to work in the United States, complete a State security questionnaire and State loyalty oath, and comply with all company and departmental policies and regulations. I understand that if employed on a temporary basis, I will be compensated only for hours worked and will not be eligible for benefits, including paid time off. I further understand that the first six (6) months of regular employment constitute a provisional period, during which I will not be eligible to apply for transfer or promotion and during which my employment may be terminated without the right of appeal.
Applicant Signature:
Date:
-
Month
-
Day
Year
Date
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