| |
| *Position
applying for: |
|
| *First
Name |
|
| Middle
Name |
|
| *Last
Name |
|
| *Email
address |
|
| *Phone
number |
|
| Cell
Phone Number |
|
| *Address |
|
| *City,
State and ZIP |
|
| Drivers
License # |
|
| State
Expiration Date (mm/dd/yy) |
|
| Social
Security # |
|
Have
you ever been
convicted of a felony? |
Yes
No
|
| If
yes, please explain: |
|
*Are
you a citizen of
the United States? |
Yes
No |
|
If
no, do you have
the legal right to work
in the United States? |
Yes
No |
|
| *Desired
Salary |
|
*Have
you ever applied
for a position here before? |
Yes
No |
|
| If
yes, when? |
|
| *Type
of employment requested |
|
*Date
you are available
to
start work (mm/dd/yy): |
|
*Summary
of professional
qualifications (please describe
why you are qualified for this
position):
|
|
| Employment
History - Current employer |
| |
|
| *Dates
of employment (mm/dd/yy): |
from:
to:
|
| *Company
Name |
|
| *Supervisor
Name |
|
| *Supervisor Title |
|
| *Address |
|
| *City,
State and Zip |
|
| *Phone
Number |
|
| *Current
job title |
|
| *Description
of work performed: |
|
| *Starting
Salary |
|
| *Current
Salary |
|
| *Reason
for leaving: |
|
*May
we contact your
current employer for
a reference? |
Yes
No |
|
| Previous
employer 2 |
| |
|
| Dates
of employment (mm/dd/yy): |
from:
to:
|
| Company
Name |
|
| Supervisor Name |
|
| Supervisor Title |
|
| Address |
|
| City,
State and Zip |
|
| Phone
Number |
|
| Job
Title |
|
Description
of work
performed: |
|
| Starting
Salary |
|
| Current
Salary |
|
| Reason
for leaving: |
|
| Previous
employer 3 |
| |
|
| Dates
of employment (mm/dd/yy): |
from:
to:
|
| Company
Name |
|
| Supervisor
Name |
|
| Supervisor Title |
|
| Address |
|
| City,
State and Zip |
|
| Phone
Number |
|
| Job
Title |
|
| Description
of work performed: |
|
| Starting
Salary |
|
| Current
Salary |
|
| Reason
for leaving: |
|
| Educational
Information |
| |
|
| *School
Name |
|
| *Degree/Diploma/Certificate |
|
| *Year
Achieved |
|
| Course
of Study |
|
| Grade
Point Avg. |
|
| Address |
|
| *City,
State and Zip |
|
| |
|
| Other School Name |
|
| Degree/Diploma/Certificate |
|
| Year
Achieved |
|
| Course
of Study |
|
| Grade
Point Avg. |
|
| Address |
|
| City,
State and Zip |
|
| |
Personal/Professional
References
Please list at least one personal and two professional
references below: |
| |
| Reference 1. |
|
| *Name |
|
| *Relationship |
|
| *Daytime
Phone |
|
| Evening/Cell
Phone |
|
| |
| Reference 2. |
|
| *Name |
|
| *Relationship |
|
| *Daytime
Phone |
|
| Evening/Cell
Phone |
|
| |
| Reference 3. |
|
| *Name |
|
| *Relationship |
|
| *Daytime
Phone |
|
| Evening/Cell
Phone |
|
| |
| By
submitting this application, I certify that the answers given
by me in this application are correct to the best of my knowledge.
I understand that any falsification of this application, whether
willingly or accidental, is grounds for disqualification of
employment consideration, or dismissal from employment if
I am hired. I authorize ITS – Integrated Telemanagement
Services, Inc., and its divisions and affiliates to contact
any and all of the references I have listed above to obtain
previous employment information or any other pertinent information
that they may have. Further, I release the above mentioned
references from any and all liability for any damages that
may result from information collected by ITS. Verification
of eligibility to work in the United States must be satisfied
for an offer to be made. |
|
*
I Agree
I Disagree |
| *Required
Fields |
|