Employment Application Applicant InformationName First Last Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Date Available Position applying for Wage/Salary desired Qualifications applicable to the position you are applying forEducationName of High School Address Did you graduate? Yes No Name of College Did you graduate? What degree did you earn? ReferencesPlease list three professional references.Name First Last PhoneRelationship Company Name First Last PhoneRelationship Company Name First Last PhoneRelationship Previous EmploymentCompany PhoneAddress Supervisor Job Title Starting Salary Ending Salary ResponsibilitiesFrom: To: Reason for Leaving Company PhoneAddress Supervisor Job Title Starting Salary Ending Salary ResponsibilitiesFrom: To: Reason for Leaving Disclaimers and SignaturesI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.Type Your Name Date I hereby authorize all previous and current employers to disclose to World Wide Sign Systems and/or the Channel Letter Factory any records necessary to determine my eligibility for employment. This includes all information regarding my service, character, conduct and attendance while in their employ. Current and former employers’ are hereby released from any and all liability, which may result from furnishing such information. This authorization is good for one year from the date below. Type Your Name Date I am consenting to a drug test and screen as a condition for my employment and consent for disclosure of results to World Wide Sign Systems and/or The Channel Letter Factory. Type Your Name Date World Wide Sign Systems and/or The Channel Letter factory will not be responsible for the completeness of this form. It is the applicant’s sole responsibility to fill out the application completely so that we can ascertain pertinent information. Applicants can be screened out for incomplete applications.Type Your Name Date Note: The Federal Immigration and Reform and Control Act of 1986 requires that an I-9 form be completed for every new hire and that it be completed no later than the first day of employment. You must bring document (s) that establish identity along with you at the time of orientation. Supporting documents must not be expired. This is a federal requirement and must be satisfied as a condition of employment. Type Your Name This application will only remain valid for 30days from the date of completion. If you wish to be considered for employment subsequent to that date, a new application must be completed. Type Your Name Resume / File UploadAccepted file types: pdf, doc, xdoc, png, jpg, Max. file size: 10 MB.PhoneThis field is for validation purposes and should be left unchanged.
