GET WIRELESS - EMPLOYMENT APPLICATION

EQUAL OPPORTUNITY EMPLOYER

 

PERSONAL INFORMATION
DATE: EMAIL ADDRESS:
NAME: (LAST, FIRST, MI) SOCIAL SECURITY NO.:
ADDRESS: CITY:
STATE: ZIP CODE:
PHONE NUMBER: REFERRED BY:
EMPLOYMENT DESIRED
POSITION: DESIRED START DATE:
DESIRED SALARY:    
ARE YOU EMPLOYED NOW: YES
 NO
 		IF SO, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER: YES
 NO
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE US? YES
 NO
 		EVER APPLIED TO THIS COMPANY BEFORE: YES
 NO
WHEN:    
EDUCATION HISTORY
HIGH SCHOOL: YEARS ATTENDED:
DID YOU GRADUATE: YES
 NO
 		SUBJECTS STUDIED:
COLLEGE: YEARS ATTENDED:
DID YOU GRADUATE: YES
 NO
 		SUBJECTS STUDIED:
GENERAL INFORMATION
SUBJECTS OF SPECIAL STUDY/RESEARCH WORK: SPECIAL TRAINING:
SPECIAL SKILLS:    
FORMER EMPLOYERS
NAME & LOCATION: FROM - TO:
SALARY: POSITION:
REASON FOR LEAVING:
NAME & LOCATION: FROM - TO:
SALARY: POSITION:
REASON FOR LEAVING:
NAME & LOCATION: FROM - TO:
SALARY: POSITION:
REASON FOR LEAVING:    

REFERENCES

NAMES OF PERSON NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR
NAME: ADDRESS:
BUSINESS: YEARS KNOWN:
NAME: ADDRESS:
BUSINESS: YEARS KNOWN:
AUTHORIZATION
ADDITIONAL INFO/COMMENTS:    

      "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

       I authorize investigation of all statements contained herein and the references and employers 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 the company from all liability for any damage that may result from utilization of such information.

       I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the American with Disabilities Act (ADA) and other relevant federal and state laws."
Please type in your full name in the box below followed by the date, as your signature of understanding of the disclosure listed above:
TYPE NAME FULL NAME: DATE: