Allied Group Career Application

Application for Employment

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition, handicap or any other legally protected status.
Please allow at least 15-20 minutes to complete our application.

The application is five (5) pages. This page is 1 of 5.
Full Name*

First NameMiddle NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Phone Number*

Area CodePhone Number
Position Desired*
Wage Desired*
Hourly or salary
When can you start?*
A specific date, month, or "immediately" is valid.
Are you a U.S. citizen?*
Yes or No
If no, please provide your alien registration
Employment in the U.S. is contingent upon proof of citizenship/immigration status.
Are you at least 18 years of age?*
Yes or No
If not, can you furnish a work permit?
Have you ever applied to Allied Group?*
Yes or No
If yes, when?
Have you ever been employed by Allied Group?*
Yes or No
If yes, when?
How did you hear about our company?*
Do you have relatives working for our company, any subsidiaries, contractors or suppliers? If yes, please list their name(s):*
Yes or No
Are you interested in working Part-Time or Full-Time?*
Are you willing to work different shifts/schedules as required by the position?*
Yes or No
Are you willing to travel as required by the position?*
Yes or No
Are you capable of performing with reasonable accommodation, the job(s) for which you are applying?*
Yes or No
Have you ever been arrested? If yes, please explain (an arrest will not disqualify you from employment)*
Have you ever been convicted of a crime? If yes, please explain (an arrest will not necessarily disqualify you from employment)*
Is there anything that would not allow you to perform the duties of the work for which you are applying? If yes, please explain:*
If no, say "N/A"

Education
The application is five (5) pages. This page is 2 of 5.
High School:
Name and Location:
No. of year(s) completed
Type of Diploma/Degree received
Additional High Schools:
For multiple high schools, please list and provide location(s), number of years completed, and type(s) of Diploma/Degree received.
Trade Business or Technical School:
Name and Location:
No. of year(s) completed
Type of Diploma/Degree received
Additional Trade Business or Technical School(s):
For multiple trade business or technical schools, please list and provide location(s), number of years completed, and type(s) of Diploma/Degree received.
College/University
Name and Location:
No. of year(s) completed
Type of Diploma/Degree received
Additional Colleges/Universities:
For multiple colleges or universities, please list and provide location(s), number of years completed, and type(s) of Diploma/Degree received.
Graduate school:
Name and Location:
No. of year(s) completed
Type of Diploma/Degree received
Additional Graduate schools:
For multiple graduate schools, please list and provide location(s), number of years completed, and type(s) of Diploma/Degree received.
Please describe any additional academic achievements or relevant extracurricular activities:

Work Experience

You must complete this section even if you attach a resume. Please list present or most recent job first. Include military service assignments and volunteer activities. You may exclude organizational names which indicate race, color, religion, sex, national origin, handicap or other legally protected status.
The application is five (5) pages. This page is 3 of 5.
May we contact your present or most recent employer?*
Yes or No
Have you ever been discharged by an employer?*
Yes or No
How many days have you been absent from work in the past 12 months?*
Number of days
Present or most recent employer:*
Job Title:*
Employer's address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's phone number:*

Area CodePhone Number
Dates employed (from):*

MonthDayYear
Date
Dates employed (to):*

MonthDayYear
Date
Hourly wage/salary (starting):*
Hourly wage/salary (final):*
Supervisor's name and title:*
Reason for leaving:*
Description of primary responsibilities:*
Previous employer:
Job Title:
Employer's address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's phone number:

Area CodePhone Number
Dates employed (from):

MonthDayYear
Date
Dates employed (to):

MonthDayYear
Date
Hourly wage/salary (starting):
Hourly wage/salary (final):
Supervisor's name and title:
Reason for leaving:
Description of primary responsibilities:
Previous employer:
Job Title:
Employer's address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's phone number:

Area CodePhone Number
Dates employed (from):

MonthDayYear
Date
Dates employed (to):

MonthDayYear
Date
Hourly wage/salary (starting):
Hourly wage/salary (final):
Supervisor's name and title:
Reason for leaving:
Description of primary responsibilities:
Previous employer:
Job Title:
Employer's address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's phone number:

Area CodePhone Number
Dates employed (from):

MonthDayYear
Date
Dates employed (to):

MonthDayYear
Date
Hourly wage/salary (starting):
Hourly wage/salary (final):
Supervisor's name and title:
Reason for leaving:
Description of primary responsibilities:
Previous employer:
Job Title:
Employer's address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's phone number:

Area CodePhone Number
Dates employed (from):

MonthDayYear
Date
Dates employed (to):

MonthDayYear
Date
Hourly wage/salary (starting):
Hourly wage/salary (final):
Supervisor's name and title:
Reason for leaving:
Description of primary responsibilities:
Additional employers:

Additional Work Experience
The application is five (5) pages. This page is 4 of 5.
Please list any additional knowledge, skill(s), qualification(s), award(s), or apprenticeship(s), that will be helpful to Allied Group in considering your application for work (include special, technical, and clerical skills).
Please list your involvement with professional organizations or business activities which will enhance your performance in the position for which you are applying.
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Applicant's Statement
The application is five (5) pages. This page is 5 of 5.
I certify that the answers given herein are true and complete.

I understand that, if employed, I will be an employee at will and have the right to terminate my work at any time and for any reason. Allied Group enjoys a similar right, regardless of cause and with or without notice. Upon my resignation or termination, I agree to return all company property in my possession or under my control. If hired, I agree to conform to all the policies, procedures, rules and regulations of Allied Group and the Work Position requirements . I acknowledge that no representation or promises regarding continued work for any specified period of time have been made to me, nor will any such representation or promise be valid or enforceable.

I authorize investigation of all statements/information provided on the Application For w. I authorize the release and investigation of any and all information, including credit related information, concerning my qualifications or considered necessary in arriving at an employment/ work decision, and waive any and all claims for liability arising out of any investigation.

I understand that this Application for Work shall be considered active for a period of not to exceed 45 days. I understand that, if I wish to be considered for work beyond this time period, I will need to reapply at that time.

I understand that this application is not an offer of work. In the event of work, I understand that false or misleading information given on this application, during the hiring process or during work may result in termination.

Under applicable law an employer may not require or demand any applicant for work or prospective work or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of work or continued work. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100. (This fine may vary by state.)
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Date
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Application for Employment

Education

Work Experience

Additional Work Experience

Applicant's Statement