Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email
*
Name of position for which you are applying
*
Desired type of employment
*
Are you eligible to work in the U.S.?
*
Are you age 18 or over?
*
Willing to relocate?
*
Date Available to Start
*
MM
DD
YYYY
How did you hear about us?
*
Have you ever been previously employed here?
*
If yes, list dates employed
Desired Salary/Hourly Wage
*
Do you have relatives employed by this organization?
*
If yes, please give name and title
Will you now, or in the future, require sponsorship for employment visa status (e.g. H-1B visa status)?
*
During the last 10 years, have you ever been convicted of a crime other than a minor traffic offense?
*
If yes, please provide details, dates and location for all convictions. *A conviction may not necessarily automatically disqualify you for employment. Rather, factors such as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered.
Are you available to work on weekends?
*
High School (Name, City, State/Province, Country)
Did you graduate?
Major/Area of study
GPA
Degree
College/University (Name, City, State/Province, Country)
Did you graduate?
Major/Area of study
GPA
Degree
Graduate School (Name, City, State/Province, Country)
Did you graduate?
Major/Area of study
GPA
Degree
Business/Trade School (Name, City, State/Province, Country)
Did you graduate?
Major/Area of study
GPA
Degree
Other (Name, City, State/Province, Country)
Did you graduate?
Major/Area of study
GPA
Degree
May we contact your present employer?
Name of Employer
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates Employed
Starting Salary
Ending Salary
Type of Employment
Your Job Title
Phone
(###)
###
####
Supervisor's Name
Supervisor's Title
Describe Major Duties
Reason for Leaving
Name of Employer
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates Employed
Starting Salary
Ending Salary
Type of Employment
Your Job Title
Phone
(###)
###
####
Supervisor's Name
Supervisor's Title
Describe Major Duties
Reason for Leaving
Name of Employer
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates Employed
Starting Salary
Ending Salary
Type of Employment
Your Job Title
Phone
(###)
###
####
Supervisor's Name
Supervisor's Title
Describe Major Duties
Reason for Leaving
Name of Employer
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates Employed
Ending Salary
Starting Salary
Type of Employment
Phone
(###)
###
####
Your Job Title
Supervisor's Name
Supervisor's Title
Describe Major Duties
Reason for Leaving
In a brief statement, in your own words, please describe why you are an ideal candidate for this position.
*
Branch
State Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Highest Rank
Duties
Branch
State Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Highest Rank
Duties
Name
Current Company
Relationship
Phone
(###)
###
####
Email
Name
Current Company
Relationship
Phone
(###)
###
####
Email
Name
Current Company
Relationship
Phone
(###)
###
####
Email
I understand that CHERBOURG will rely, in part, on the information I provide in this Employment Application in considering whether to hire me. I understand that it is important that I provide complete and accurate information and certify that I have done so. If CHERBOURG discovers at any time that I failed to completely and honestly provide any information requested of me in this Employment Application or during the interview process, I understand that my application will no longer be considered or, if I am working for CHERBOURG, that I will be subject to disciplinary action, up to and including termination of employment.
CHERBOURG is committed to compliance with the provisions of this nation’s immigration laws regarding verification of employment eligibility. Any offer of employment will be contingent upon your ability to provide legally sufficient documentation showing your eligibility to be employed by CHERBOURG. Applicants or employees that present fraudulent documents for employment verification purposes will be terminated.
I authorize CHERBOURG to contact anyone that it deems appropriate to verify the information I have provided or to further investigate my background, past performance and suitability for employment. I consent to being discussed by any person contacted by CHERBOURG and waive all rights to bring any action for defamation, invasion of privacy or any similar claim against anyone that provides information to CHERBOURG with a good faith belief that the information provided is true. I understand that CHERBOURG may choose to obtain background information about me from a consumer reporting agency. Before requesting a report from a consumer reporting agency, CHERBOURG will ask for my authorization. I understand that if I refuse to provide such authorization, my application for employment will not be considered.
I understand that this Employment Application is not an offer of employment. I understand that nothing contained in this Employment Application creates a contract between CHERBOURG and me for employment or any other benefit. No promises regarding employment have been made and I understand that no such promise or guarantee is binding upon CHERBOURG.
I understand that if I am hired, I will be an employee "at will," meaning I am not hired for any definite length of time and either I or CHERBOURG can terminate my employment at any time for any or no reason.
If employed, I understand and agree that CHERBOURG retains the sole right in its business judgment to modify, suspend, interpret, or cancel, in whole or in part, at any time, with or without any notice, any published or unpublished policy, practice, procedure, process, or benefit.
If employed, I understand that I may be required to comply with Federal, State/Province, or Local Data Privacy and other applicable regulations. I understand and agree to comply with such laws.
If employed, I understand that as a condition of employment that I may be required to agree to and sign CHERBOURG’s confidentiality, non-compete, and/or other similar agreements. I also agree to notify CHERBOURG during the pre-employment process of any confidentiality, non-compete, and/or other similar agreements that I may have already signed with current and/or former employers, or other potential conflict.
I understand that the technical processing and transmission of the application, including my personal information, may involve (a) transmissions over various networks, including the transfer of this information to the United States and/or other countries for storage, processing and use by its affiliates, and their agents; and (b) changes to conform and adapt to technical requirements of connecting networks or devices. Accordingly, I agree to permit such parties to make such transmissions and changes, and hereby provide the necessary consent for the same.
Date
*
MM
DD
YYYY
