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Employment Application

Employment Application

Position Applied For:*
Location*
Attach Resume
Applicant Information
Full Name*
First Last
Middle Name*
Address*
Street Address City State ZIP Code
E-mail Address
Home Phone*
Work Phone
Emergency Contact (Full Name)*
First Last
Emergency Contact Phone*
Relationship to Emergency Contact*
Any History of Felony Convictions? (if yes, please explain)*
- Yes
- No
Year
Explanation
Education History
High School*
# Of Years Completed*
*
- Diploma
- GED
College/Trade School
City/State
Degree
Major/Study
# Of Years Completed
Did You Graduate?
- Yes
- No
Employment History
Company #1
City/State
Phone
Title
Job Description
Supervisor
Dates
Date Format: MM slash DD slash YYYY
to
Date Format: MM slash DD slash YYYY
Reason For Leaving
Starting Pay
Ending Pay
Company #2
City/State
Phone
Title
Job Description
Supervisor
Dates
Date Format: MM slash DD slash YYYY
to
Date Format: MM slash DD slash YYYY
Reason For Leaving
Starting Pay
Ending Pay
Company #3
City/State
Phone
Title
Job Description
Supervisor
Dates
Date Format: MM slash DD slash YYYY
to
Date Format: MM slash DD slash YYYY
Reason For Leaving
Starting Pay
Ending Pay
I certify that all information furnished on this application is true, complete, and correct. I understand and agree that any falsification, misrepresentation, misleading statement or omission of fact on either this application or during the pre-hire process will be sufficient reason for my not being offered employment or dismissal at any time from Axios, if employed. I also understand that my employment and compensation is for no definite period and may be terminated at any time by me or Axios with or without cause and without previous notice. I acknowledge that no company employee has the power to enter in agreement for employment for any specified amount of time, or to make any agreements contrary to any of the above unless it is in writing and authorized by the company’s President. As a condition of employment, I agree to a 180-day statue of limitations for all employment-related claims.
Applicant Signature

Type Your Full Legal Name
Date
Date Format: MM slash DD slash YYYY