EMPLOYMENT APPLICATION

PERSONAL INFORMATION
FIRST NAME MIDDLE NAME LAST NAME EMAIL
PRESENT ADDRESS CITY STATE ZIP
PERMANENT ADDRESS CITY STATE ZIP
PHONE NO. ARE YOU 18 OR OLDER?
EMPLOYMENT DESIRED
SELECT YOUR CATEGORY SELECT YOUR POSITION DATE YOU CAN START: SALARY DESIRED
Choose a Date   $  
ARE YOU EMPLOYED NOW? MAY WE CONTACT YOUR PRESENT EMPLOYER?
HAVE YOU APPLIED TO THIS COMPANY BEFORE? WHERE? WHEN?
REFERRED BY?
EDUCATION
HIGH SCHOOL
NAME AND LOCATION OF SCHOOL # OF YEARS ATTENDED
 
DID YOU GRADUATE? SUBJECT STUDIED
COLLEGE
NAME AND LOCATION OF SCHOOL # OF YEARS ATTENDED
 
DID YOU GRADUATE? SUBJECT STUDIED
GRADUATE
NAME AND LOCATION OF SCHOOL # OF YEARS ATTENDED
 
DID YOU GRADUATE? SUBJECT STUDIED
TRADE, BUSINESS OR CORRESPONDENCE
NAME AND LOCATION OF SCHOOL # OF YEARS ATTENDED
 
DID YOU GRADUATE? SUBJECT STUDIED
GENERAL
SPECIAL SKILLS
TYPING SPEED (WPM) PC SOFTWARE/OTHER EQUIPMENT
 
ACTIVITIES (CIVIC,ATHLETIC,ETC.)

Exlude organizations, the name of which indicates the race, creed, sex, age, marital status, color or nation of origin of its members
U.S. MILITARY OR
NAVAL SERVICE
RANK PRESENT MEMBERSHIP IN NATIONAL GUARD OR RESERVES
LEGAL
ARE YOU AUTHORIZED TO WORK IN THE U.S. ON AN UNRESTRICTED BASIS?
(Identity and employment eligibility of all new hires will be verified as required by the Immigration Reform and Control Act of 1986)
WERE YOU EVER DISCHARGED BY ANY COMPANY? IF YES, GIVE NAME OF COMPANY(IES)
REASON FOR DISCHARGE
HAVE YOU EVER BEEN CONVICTED OF A CRIME OTHER THAN A MINOR TRAFFIC VIOLATION?
IF YES, EXPLAIN OFFENSE AND FINAL DISPOSITION:
 
EMPLOYMENT HISTORY
LIST BELOW THE LAST FOUR EMPLOYERS, STARTING WITH THE MOST RECENT POSITION.
#1
MONTH AND YEAR NAME ADDRESS
From To
PHONE # OF EMPLOYER POSITION HELD AND SUPERVISOR
LIST MAJOR DUTIES SALARY OR WAGES REASON FOR LEAVING
Starting $  Final $ 
#2
MONTH AND YEAR NAME ADDRESS
From To
PHONE # OF EMPLOYER POSITION HELD AND SUPERVISOR
LIST MAJOR DUTIES SALARY OR WAGES REASON FOR LEAVING
Starting $  Final $ 
#3
MONTH AND YEAR NAME ADDRESS
From To
PHONE # OF EMPLOYER POSITION HELD AND SUPERVISOR
LIST MAJOR DUTIES SALARY OR WAGES REASON FOR LEAVING
Starting $  Final $ 
#4
MONTH AND YEAR NAME ADDRESS
From To
PHONE # OF EMPLOYER POSITION HELD AND SUPERVISOR
LIST MAJOR DUTIES SALARY OR WAGES REASON FOR LEAVING
Starting $  Final $ 
WHICH OF THESE JOBS DID YOU LIKE THE BEST?
WHAT DID YOU LIKE MOST ABOUT THE JOB?
 
REFERENCES
GIVE THE NAMES OF THREE REFERENCES, TWO MUST BE PROFESSIONAL, WHOM YOU HAVE KNOWN ATLEAST ONE YEAR.
#1
NAME ADDRESS PHONE #
BUSINESS/TITLE YEARS KNOWN TYPE
 
#2
NAME ADDRESS PHONE #
BUSINESS/TITLE YEARS KNOWN TYPE
 
#3
NAME ADDRESS PHONE #
BUSINESS/TITLE YEARS KNOWN TYPE
 
 
PLEASE READ CAREFULLY

IN SUBMITTING THIS APPLICATION FOR EMPLOYMENT, I UNDERSTAND THAT AN INVESTIGATION MAY BE MADE WHEREBY INFORMATION IS OBTAINED REGARDING MY CHARACTER, PREVIOUS EMPLOYMENT, GENERAL REPUTATION, EDUCATIONAL BACKGROUND, CREDIT RECORD AND/OR CRIMINAL HISTORY. I AUTHORIZE ANYONE POSSESSING THIS INFORMATION TO FURNISH IT TO NSDS GROUP, INC AND/OR A THIRD PARTY COMPANY UPON REQUEST AND I RELEASE ANYONE SO AUTHORIZED, NATION SAFE DRIVERS, AND ANY THIRD PARTY COMPANY FROM ALL LIABILITY AND DAMAGES WHATSOEVER IN FURNISHING, OBTAINING OR USING SAID INFORMATION.

IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW(S) MAY RESULT IN IMMEDIATE DISMISSAL. I UNDERSTAND, ALSO, THAT I AM REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF NSDS GROUP, INC.

I UNDERSTAND AND AGREE THAT IF EMPLOYED, THE EMPLOYMENT WILL BE "AT WILL". THAT IS, EITHER NSDS GROUP, INC MAY END THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, OR FOR NO REASON. I UNDERSTAND THAT RECEIPT OF THIS APPLICATION BY NSDS GROUP, INC DOES NOT IMPLY EMPLOYMENT AND THAT THIS APPLICATION AND/OR ANY OTHER NSDS GROUP, INC DOCUMENTS ARE NOT CONTRACTS OF EMPLOYMENT.

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