AIS Application

Education:
High School: Name, City & State of School
Course of Study
Years completed
Did you graduate?
Type of diploma, degree or certificate
Technical/Trade School: Name, City & State of School
Course of Study
Years completed
Did you graduate?
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College: Name, City & State of School
Course of Study
Years completed
Did you graduate?
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Other: Name, City & State of School
Course of Study
Years completed
Did you graduate?
Type of diploma, degree or certificate
Specify professional designations, certifications, license or registrations held:
Describe additional skills, training or ability you would like to have us consider in evaluating your qualifications:
References: List three references that are not related to you.
1. Name
Phone Number
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Relationship
2. Name
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Relationship
3. Name
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Relationship

Employment: List most recent employer first
1. Company: *
Phone Number
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Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment*
Supervisor:
Starting Rate of Pay:
Current or Ending Pay:
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Reason for leaving:*
Job Title and Duties:*
2. Company:
Phone Number
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Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment:
Supervisor
Starting Rate of Pay:
Current or Ending Pay:
May we contact this company?

YesNo
Reason for leaving:
Job Title and Duties:
3. Company
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment:
Supervisor:
Starting Rate of Pay:
Current or Ending Pay:
May we contact this company?

YesNo
Reason for leaving:
Job Title and Duties:

Advanced Industrial Services, Inc and AIS Graphic Serives, Inc. is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex marital status, national orgin, disability, or handicap or veteran status.
Disclaimer: I understand that if employed by AIS, Inc., my employement will be at-will, and not for a set period of time and may be terminated by me or AIS, Inc. at any time without notice or reason or cause. I understand that nothing will change the at-will status of my employment other than the execution of a written agreement by me and an authorized representative of AIS, Inc., that expressly changes the at-will status.
Verification of Information: I certify that the information provided on this application (and accopmanying documents, if any) is true and complete to the best of my knowledge. I agree that falsified information or significant omission may disqualify me from further consideration of employment, and, if employed, may result in my termination.
Applicant Testing: I understand that I will be required to submit to and pass an 8 panel urine drug test as a condition of my employment.
Authorization: I authorize AIS, Inc. to investigate all statements contained in this application (and accopmanying documentation, if any) and to make inquiries as may be necessary in determining an employment decision. I hereby release employers, schools or persons from any and all liability in responding truthfully to inquiries related to my application for employment.
I understand that if accepted for employment, it is necessary to abide by the rules and policies of AIS, Inc.
Signature:
Date:

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All applications are valid for 60 days from the date signed
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Application for Employment

Personal Information:

Employment Desired

Education:

References: List three references that are not related to you.

All applications are valid for 60 days from the date signed