Employment Application

I authorize my former employers to provide the employer any information regarding my employment and medical records, including and in addition to the above, and I release all parties from any liability for any damages which may result from furnishing such information. I also agree to permit the employer to conduct any other background investigative procedures it deems appropriate with respect to my application and, in the event of hire, while employed. I also understand and agree that my employment, compensation and hours of work are for no definite period and may, regardless of the time and manner of payment on my wages and salary, be terminated at any time by me or the employer, with or without cause, and without any previous notice. I also understand and agree that the employer has the right to unilaterally modify and/or terminate any policies, practices, procedures, and standards it has adopted or implemented, to the extent not limited by law. I acknowledge that no representative, other than the employer, has either the power or authority to enter into any agreement for employment for any specified period of time, or to make any representations or agreements contrary to any of the forgoing, unless that agreement is in writing and signed by the employer.

Personal Information

Emergency Contact

Employment Desired

Skills

Reference Two

Education

Present or Most Recent Employment

Second Most Recent Employer

Third Most Recent Employer

References

Reference One

Reference Three