Please list periods of employment beginning with the most recent. You must include all concurrent employment.
Resumes will not be accepted in lieu of completing this Section. If you need extra space please attach additional sheets.
Name of Present or Last Employer: Phone:
Address: Supervisor:
Job Title: From: To:
Responsibilities:
Reason for Leaving: May we contact them? Yes No
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Previous Employer: Phone:
Address: Supervisor:
Job Title: From: To:
Responsibilities:
Reason for Leaving: May we contact them? Yes
No
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Previous Employer: Phone:
Address: Supervisor:
Job Title: From: To:
Responsibilities:
Reason for Leaving: May we contact them?
Yes No
I certify that the above information is true and correct and give authorization for investigation of all statements and information contained in this
application,
my resume, other documents or verbally obtained during an employment interview. I voluntarily consent to allow Jr's Academy or any
of their representatives or agents to check my references by contacting any persons, company or governmental entity they deem to be an
appropriate reference. I understand the reference questions may pertain to my personal or educational background, work experience, character
and behavior. I understand my employment is subject to satisfactory verification of this information and agree that deliberate falsification of this
document or significant omissions shall be grounds for employment consideration disqualification or dismissal from employment, if discovered at a
later date.
I pledge, if hired, to comply with the guidelines of conduct and company policies and procedures of Jr's Academy. I also realize that company
policies, procedures, practices or statements made during an interview or employment do not create an employment contract by implication or
otherwise. I further understand and agree that my employment is for no definite period of time and may, regardless of time and manner be
terminated by the company or myself with or without cause or previous notice.
I understand that employment will be subject to satisfactory completion of obtaining finger printing and a background check investigation.
Signature:
Date:
This application does not constitute an employment contract for a term of employment and may be revised or discarded at the employer's
discretion. Personal Privacy: The information you are providing on this application is being requested for the principal purpose of
determining eligibility for initial and continued employment. The information may also be used in administering employee benefit programs.
Failure to provide the requested information may hinder your possible hiring and subsequent administration of your employee benefits.
Applicant Affirmation & Release Authorization
Jr's Academy
