Application for Employment



Return to Careers
Today's Date:(mm/dd/yyyy)
Personal Information

Name(Last,First, MI):

Social Security Number:


Present Address:



City:



State:

Zip:


Permanent Address:

City:

State:
Zip:
Phone Number: Referred By:
Employment Desired
Position: Date You Can Start Salary Desired Annually
Are You Employed Now? If so, May we inquire of your present employer?
Are you legally authorized to work in the U.S.?
Education History
Name and Location
High School Years Attended: Did you Graduate?
Subjects Studied:

College

Years Attended:
Did you Graduate?
Subjects Studied:

Other Education

Years Attended:
Did you Graduate?
Subjects Studied:
General Information
Subjects of Special Study:

Special Training:


Military or Naval Service:
Rank:
Former Employers
Date (mm/dd/yyyy)
Name & Address of Employer
Salary
Position
 Reason for Leaving
From: 
To:    
From:   
To:     
From:   
To:     
References
Give the names of three persons not related to you, whom you have known at least one year.

Name:
Address:

Business:
Years Known:

Name:
Address:

Business:
Years Known:

Name:
Address:

Business:
Years Known:


Authorization

By submitting this application you are certifying that the facts contained in this application are true and complete to the best of your knowledge and understand that, if employed, falsified statements shall be grounds for dismall.

You authorize investigation of all statements herein and the references and employers listed above to give DocuStor any and all information concerning your previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

You also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of the disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.