EMPLOYMENT APPLICATION



APPLICANT INFORMATION

Date of Application
Last Name, First Name and Middle Initial
Address
E-mail
Home Phone
Cell Phone


EMPLOYMENT DETAILS

Postion(s) applied for
Dates Available for Work
Desired Salary
Have you ever worked for The Cross Group? If so, when?
Are you a citizen of the Untied States?
Do you hold a valid driver’s license?    Yes
   No
Answering "Yes" to this question does not constitute an automatic bar to employment.  Factors such as the date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.
Have you ever pled quilty or no contest to, or been convicted of a crime?


EMPLOYMENT EXPERIENCE

Please provide the following information for your last 4 employers, assignments or volunteer activities, starting with the most recent.

1. Name of employer / Address / City, State, Zip Code / Phone number
Starting Job Title/ Final Job Title
Dates Employed (From - To)
Hourly Rate/Salary (Starting - Final)
Supervisor
Reason for Leaving
May we contact your previous supervisor for a reference?    Yes
   No
2. Name of employer / Address / City, State, Zip Code / Phone number
Starting Job Title/ Final Job Title
Dates Employed (From - To)
Hourly Rate/Salary (Starting - Final)
Supervisor
Reason for Leaving
May we contact your previous supervisor for a reference?    Yes
   No
3. Name of employer / Address / City, State, Zip Code / Phone number
Starting Job Title/ Final Job Title
Dates Employed (From - To)
Hourly Rate/Salary (Starting - Final)
Supervisor
Reason for Leaving
May we contact your previous supervisor for a reference?    Yes
   No
4. Name of employer / Address / City, State, Zip Code / Phone number
Starting Job Title/ Final Job Title
Dates Employed (From - To)
Hourly Rate/Salary (Starting - Final)
Supervisor
Reason for Leaving
May we contact your previous supervisor for a reference?


SKILLS & QUALIFICATIONS

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.


EDUCATION BACKGROUND (if job related)

Provide information for school attended below. Include name of school, location, number of years completed, if you received a degree/diploma and course of study.

High School
College
Other


REFERENCES

1. Name
Phone
Number of years knows
2. Name
Phone
Number of years known
3. Name
Phone
Number of years known


APPLICATION STATEMENT


I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me form the employer’s service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional(, employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representative, for seeking, gathering and using such information in the employment process and all other persons , corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate any employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United State and that federal immigration laws require me to complete an I-9 Form in this regard.

I certify that I have read, fully understand, and accept all terms of the forgoing application statement
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