Bliss Employment Application

Employment Application

Bliss Climbing Corporation
We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability.
Full Name*

First NameMiddle NameLast Name
Date of Application*

MonthDayYear
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Email Address

General Information
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?*

NoYes
Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.)*

NoYes
If yes, please explain.

Education & Training
Select last grade completed.*
Name and Address of School
Last High School Attended/Address*
Graduated/GED*

NoYes
Average Grade*
College or University/Address
Major course studied
Graduated or Degree

NoYes
Average Grade
College or University/Address Other School (Technical, Vocational, Graduate, etc.) /Address
Major course studied
Graduated or Degree

NoYes
Average Grade
List any scholarships, academic honors, awards or special achievements:

Employment History
Starting with your PRESENT or MOST RECENT EMPLOYER list in consecutive order ALL EMPLOYMENT for at least the past FOUR employers.
If currently employed, may we contact your employer?

NoYes
PRESENT OR MOST RECENT EMPLOYER
Full name of company
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Name and title of supervisor
Title of your position
List jobs held, duties performed, skilled used, & promotions while employed at this company:
Salary: Begin - End
Employed: From MM/YY to MM/YY
Reason for leaving:

Add a second employer
Full name of company
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Name and title of supervisor
Title of your position
List jobs held, duties performed, skilled used, & promotions while employed at this company:
Salary: Begin - End
Employed: From MM/YY to MM/YY
Reason for leaving:

Add a third employer
Full name of company
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Name and title of supervisor
Title of your position
List jobs held, duties performed, skilled used, & promotions while employed at this company:
Salary: Begin - End
Employed: From MM/YY to MM/YY
Reason for leaving:

Add a fourth employer
Full name of company
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Name and title of supervisor
Title of your position
List jobs held, duties performed, skilled used, & promotions while employed at this company:
Salary: Begin - End
Employed: From MM/YY to MM/YY
Reason for leaving:

Please attach your personal resume.

Feel free to send your resume later to info@climbbliss.com
Resume

Upload a File

Cancelof

READ CAREFULLY: I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I also give my consent to a full background check prior to employment and as a part of the application process.
By checking this box, I am agreeing to the statement above.*

I agree
Signature*
Type Signature
Name: {fullName}
Date of signature*

MonthDayYear
Please verify that you are human*
Should be Empty:

Employment Application