JB Fitzgerald Venture Capital Employment Form

JB Fitzgerald Venture Capital Career Inquiry

Please, no calls, emails, messages, personal inquiries to members of the team, or requests for meetings. We seek to give all applicants a fair chance regardless of personal connection.
Date*

MonthDayYear
Date
Available start date:*

MonthDayYear
Full Name*

First NameMiddle NameLast Name
Social Security #*
Driver's License #*
Type n/a if not applicable
Which state was your driver's license issued?*
Type n/a if not applicable
Are you legally authorized to be employed in the USA?*
Current Address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permanent Address?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
What Type of Employment Desired?*
Date of Birth?*

MonthDayYear
Date
Male or Female?
Have you ever been convicted of a criminal offense? (DUI, Theft) If yes, please list dates and explain*
Type n/a if not applicable.
Education Information

What is your present year in school?*

	1	2	3	4
High School
College
Graduate

High School*
Course of Study*
Graduated?*
G.P.A.*
College
Course of Study
Graduated?
G.P.A.
Degree Received
Employment History

List all work experience beginning with your current or most recent position.
Company Name*
Address*
Employed From - To*
Name/Title of Supervisor*
Supervisor's Email*
Direct Telephone*
Your Title*
Reason for Leaving*
Description of Responsibilities*
Company Name*
Address*
Employed From - To*
Name/Title of Supervisor*
Supervisor's Email*
Direct Telephone*
Your Title*
Reason for Leaving*
Description of Responsibilities*
Company Name*
Address*
Employed From - To*
Name/Title of Supervisor*
Supervisor's Email*
Direct Telephone*
Your Title*
Reason for Leaving*
Description of Responsibilities*
May we contact the employers listed above? If not, indicate the one(s) you do not wish us to contact. *
Personal References

List three individuals able to give character references. You should include former employers or school administrators, but not your relatives. A reference form has been included with this application to make copies of. They may be returned separately by the individuals filling them out, but must be received by JB Fitzgerald Venture Capital LLC in order to process this application.
Reference 1*

Full Name

Address

PhoneOccupation

Relationship to Applicant
Reference 2*

Full Name

Address

PhoneOccupation

Relationship to Applicant
Reference3*

Full Name

Address

PhoneOccupation

Relationship to Applicant
IMPORTANT - PLEASE NOTE
- If you are offered a position with JB Fitzgerald Venture Capital LLC, we will need your signature authorizing a criminal background check.  
- JB Fitzgerald Venture Capital LLC policy requires all staff to have a physical exam within 24 months prior to work.  
- Alcohol, tobacco, and tobacco product use are forbidden on campus, even if the employee is of the legal age to partake in these substances. Tobacco & Alcohol use is limited to personal time, off campus, and not in view of student-athletes.  
- Alcohol, Drugs, and Tobacco are not allowed on JB Fitzgerald Venture Capital LLC leased or owned property.
Statement of Purpose

I certify that my application and all attachments are true and complete to the best of my knowledge. I understand that any incorrect, incomplete, or false statements or information furnished by me may, at the discretion of the JB Fitzgerald Venture Capital LLC, disqualify me from employment, or cause my dismissal. I hereby authorize JB Fitzgerald Venture Capital LLC to perform an official Criminal Background Check on me. I release from liability JB Fitzgerald Venture Capital LLC, former employers, or any persons supplying referred information. The language in this application is not intended to create, nor is it to be misconstrued to constitute, a contract of employment.
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JB Fitzgerald Venture Capital Career Inquiry

Education Information

Employment History

Personal References

IMPORTANT - PLEASE NOTE

Statement of Purpose