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Application for Employment Form
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Personal Employment Information
 
Full Name Position Applying For
Social Security # Email Address
Present Address City, State, Zip

Telephone Number

 
* We will require your SS# in order to proceed with your application; however,
if you are reluctant to provide electronically, please call or e-mail the information
Are you legally eligible for employment in the U.S.A?
Have you applied with us previously?  When? 
Are you employed now?
Please list any skills or qualifications beneficial in the job for which you are applying for


Record of Education
 
Name of High School Did you Graduate?
Address of High School  
 
Name of College Did you Graduate?
Address of College Course of Study
 
Other Education
Specify

Record of Employment
 
Name of Company Date Started
Address of Company Date Ended
Telephone Salary
Name of Supervisor Reason for Leaving
Describe the Work you Performed (Include Job Titles)
 
Name of Company Date Started
Address of Company Date Ended
Telephone Salary
Name of Supervisor Reason for Leaving
Describe the Work you Performed (Include Job Titles)
 
Name of Company Date Started
Address of Company Date Ended
Telephone Salary
Name of Supervisor Reason for Leaving
Describe the Work you Performed (Include Job Titles)
 

Please Read and Initial Below

The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application would be grounds for dismissal. I further understand that this application is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me. I understand and agree that my employment is at-will and can be terminated with or without notice, at any time, for any or no reason.

I authorize Sencore, Inc. to make a thorough investigation of my past employment, education, credit history and job related activities and I release from all liability all persons, companies, and corporations supplying such information. I also indemnify Sencore, Inc. against liability which might result from making such investigation. Additionally, I authorize Sencore, Inc. to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that Sencore, Inc. deems appropriate. I understand that if employed by Sencore that any annual wage stated is a rate to be paid bi-weekly.

The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, creed, religion, sex or national origin. Federal law also prohibits other types of discrimination such as age, citizenship, disability, veteran status, attainment of benefits, and participation in union activities. The laws of most states and many localities also prohibit some or all of the above types of discrimination as well as some additional types including, but not limited to, discrimination based upon ancestry, marital status, parental status, sexual orientation, or source of income. The Fair Credit Reporting Act imposes restrictions with respect to credit data.


I have read & understand the above statements
Initials Date