GWC Employment Application

GWC Employment Application

All applicants are considered for all positions without regard to race, religion, color, sex,gender, sexual orientation, pregnancy, age, national origin, ancestry,physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal,state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs,services, and employment is available to all qualified persons. Those applicants requiring an accommodation to complete the application and/or interview process should contact a management representative.
Applicant Information
Position Applying For
Date of Application

MonthDayYear
Date
Full Name

First NameMiddle NameLast Name
Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Main Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Employment History

List the names of your present or previous employers in chronological order with present or most recent employer listed first. Be sure to account for all periods of time. If self-employed, give company name and supply business references. Add an additional page if necessary.
Employer 1 Company Name
Employer 1 Supervisor Name
May We Contact Employer 1?
Employer 1 Address
Employer 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 1 Dates Employed From

MonthDayYear
Date
Employer 1 Dates Employed To

MonthDayYear
Date
Employer 1 Job Title and Duties
Employer 1 Reason for Leaving
Employer 2 Company Name
Employer 2 Supervisor Name
May We Contact Employer 2?
Employer 2 Address
Employer 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 2 Dates Employed From

MonthDayYear
Date
Employer 2 Dates Employed To

MonthDayYear
Date
Employer 2 Job Title and Duties
Employer 2 Reason for Leaving
Employer 3 Company Name
Employer 3 Supervisor Name
May We Contact Employer 3?
Employer 3 Address
Employer 3 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 3 Dates Employed From

MonthDayYear
Date
Employer 3 Dates Employed To

MonthDayYear
Date
Employer 3 Job Title and Duties
Employer 3 Reason for Leaving
Other Employment Questions
Have you ever been involuntarily terminated or asked to resign from any job?
If yes, please explain
Please explain any gaps in your employment history
Other experience, job-related skills, additional languages, or other qualifications
Education
High School - School Name
High School - Diploma/Degree
College/University - School Name
College/University - Diploma/Degree
College/University - Area of Study / Major
Trade - School Name
Trade - Diploma/Degree
Trade - Area of Study / Major
Business/Professional References
Reference 1 Name

First NameLast Name
Reference 1 Relationship
Reference 1 Phone or Email
Reference 2 Name

First NameLast Name
Reference 2 Relationship
Reference 2 Phone or Email
Reference 3 Name

First NameLast Name
Reference 3 Relationship
Reference 3 Phone or Email
Personal References
Reference 1 Name and Title
Reference 1 Relationship and Years Acquainted
Reference 1 Phone Number or Email
Reference 2 Name and Title
Reference 2 Relationship and Years Acquainted
Reference 2 Phone Number or Email
Reference 3 Name and Title
Reference 3 Relationship and Years Acquainted
Reference 3 Phone Number or Email
Other Questions
Have you ever used another name?
Is additional information about name changes, assumed name, or nickname necessary?
If yes to either of the above, please explain
Have you ever worked for this company before?
If yes, please provide dates and position
Do you have friends and/or relatives working for this company?
If yes, please provide name(s) and relationship(s)
Availability & Work Conditions
Date Available to Begin Work

MonthDayYear
Date
Monday Availability (hours)
Tuesday Availability (hours)
Wednesday Availability (hours)
Thursday Availability (hours)
Friday Availability (hours)
Availability Type
Reliable transportation to and from work
Able to travel if the position requires it
Able to relocate if the position requires it
At least 18 years old
Can present evidence of identity and legal right to work in this country
Able to perform the essential job functions with or without reasonable accommodation
Applicant Statement & Signature

Read and initial each paragraph below. Ask if there is anything that you do not understand.
Applicant Initials

I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.
Applicant Initials

In the event of my employment with the company, I understand that I am required to comply with all rules and regulations of the company.
Applicant Initials

If hired, I understand and agree that my employment with the company is at will and that neither I nor the company is required to continue the employment relationship for any specific term. I further understand that the company or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.
Applicant Initials

I understand that the safety of employees is extremely important to the company and that the company is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.
Applicant Initials

I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
Applicant Initials

I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration law requires me to complete an I-9 Form in this regard.
Applicant Initials

I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed, and the remainder of this Agreement shall be enforceable.
Applicant Signature

My signature attests to the fact that I have read, understand, and agree to all of the above terms.
Applicant Name (Print)
Application Signature Date

MonthDayYear
Date
Should be Empty:

GWC Employment Application

Applicant Information

Employment History

Other Employment Questions

Education

Business/Professional References

Personal References

Other Questions

Availability & Work Conditions

Applicant Statement & Signature