| personal information: |
| *first name: |
|
| *middle name: |
|
| *last name: |
|
| *phone cell phone/alternate: |
|
| *e-mail: |
|
| *address: |
|
| * city
*state
*zip code
|
| *are you 18 or older? yes
no
|
| can you provide documentation to verify your identity and legal authority to work in this country? yes
no |
| position applying for |
| for what position or type of work are you applying (list up to three): |
|
| are you interested in: |
|
| full-time:
part-time:
temporary summer:
|
| dates available to start:
day/hours available:
|
| will you relocate? yes
no
|
| are you willing to work overtime? yes:
no:
|
| what prompted you to apply to enyiaanise? |
| walk-in:
friend:
other:
|
| if applying for a service position, are you currently licensed? yes:
no:
|
| if not, when will you be licensed? |
|
| this section must be completed by the applicant, include volunteer and military experience. list complete employment history, but do not provide dates of employment for jobs held more than five years ago. |
| are you presently employed? yes:
no:
|
may we contact your present employer? yes:
no:
|
| present employer |
| employer present: |
|
| phone: |
|
| manager's name: |
|
| address: |
|
| job title: |
|
| salary or wages: |
|
| hours per week: |
|
| date of last increase: |
|
| salary commission incentive earnings? yes:
no:
|
| average annual earnings: |
|
| nature of duties: |
|
| reason for leaving or seeking change: |
|
| |
|
| employer previous: |
|
| phone: |
|
| manager's name: |
|
| address: |
|
| job title: |
|
| salary or wages: |
|
| hours per week: |
|
| date of last increase: |
|
| salary commission incentive earnings? yes:
no:
|
| average annual earnings: |
|
| nature of duties: |
|
| reason for leaving or seeking change: |
|
| |
|
| employer previous: |
|
| phone: |
|
| manager's name: |
|
| address: |
|
| job title: |
|
| salary or wages: |
|
| hours per week: |
|
| date of last increase: |
|
| salary commission incentive earnings? yes:
no:
|
| average annual earnings: |
|
| nature of duties: |
|
| reason for leaving or seeking change: |
|
| list any activities, experiences, achievements or other special skills not mentioned elsewhere that relate to the position(s) for which you are applying (e.g., computer skills, retail experience, presentation/selling skills.) |
|
| education |
| name of high school location: |
|
| diploma or GED? yes:
no:
|
| advanced education (college, university or vocational/technical) |
| #1 |
|
| name of institution location: |
|
| did you graduate? yes:
no:
|
| number of year attended: |
|
| degree or certificate granted credits major/minor: |
|
| primary areas of study: |
|
| |
|
| #2 |
|
| name of institution location: |
|
| did you graduate? yes:
no:
|
| number of year attended: |
|
| degree or certificate granted credits major/minor: |
|
| primary areas of study: |
|
| |
|
| #3 |
|
| name of institution location: |
|
| did you graduate? yes:
no:
|
| number of year attended: |
|
| degree or certificate granted credits major/minor: |
|
| primary areas of study: |
|
| |
|
| other training |
|
| list other courses of training you received which you feel would be useful in evaluating your qualifications for the position(s) you are seeking. |
|
| references |
| provide the names of three persons not related to you whom you have know at least one year. |
| #1 |
|
| name: |
|
| address: |
|
| phone: |
|
| years acquainted: |
|
| |
|
| #2 |
|
| name: |
|
| address: |
|
| phone: |
|
| years acquainted: |
|
| |
|
| #3 |
|
| name: |
|
| address: |
|
| phone: |
|
| years acquainted: |
|
have you ever been convicted of a misdemeanor, felony or in a military court martial? (omit minor traffic violations) yes:
no:
if yes, give date and explain |
|
| authorization, acknowledgment and release |
i authorize enyiaanise, inc to make inquiries of my past and present employers, personal references, schools and all other information sources of which enyiaanise, inc becomes aware during the pre-employment investigation of me. i waive any confidentiality privilege i may have as to any information which is the subject of hose inquiries. i release from all liability those providing and receiving such information about me and i release enyiaanise, inc from any claims i might have or that might arise from its inquiries, in exchange for enyiaanise, inc considering me for employment.
i understand an acknowledge that full-time employment will be conditioned upon a favorable health evaluation process, which may include a physical examination. i understand that there may be a health evaluation process for part-time and other types of employment as well. i understand that future chemical screening may be required after employment.
i understand and acknowledge that if any misrepresentation or omission of material facts has been made by me or the results of any investigation are not satisfactory for any reason, any consideration, offer or actual employment by enyiaanise, inc may be terminated immediately without obligation or liability to me other than payment of the rate agreed upon for service actually rendered if i had been employed.
i understand that nothing contained in this employment application or the granting o an interview, and no company policies, procedures or handbooks that i might receive, are intended to create an employment contract between enyiaanise, inc and myself for either employment or for the providing of any benefit. no promises regarding employment have been made to me and i understand that no such promise or guarantee is binding upon enyiaanise, inc unless made in writing. if an employment relationship is established, i understand that i have the right to terminate my employment at any time and that enyiaanise, inc retains a similar right. i also understand that if i am hired, i will be required to sign an employment agreement as a condition of my employment. |
| |
| * |
| applicant's signature* (please type here, an actual signature will be required to process the application.) |
| date: |
| |
|
