Employment Application

APPLICATION FOR EMPLOYMENT.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER.

Instructions: Please print all information and complete every part of this application. If there is a question which does not apply to you, mark "N/A." Do not leave any question unanswered. Any false, misleading, or incomplete responses may result in disqualification for hire or immediate dismissal from employment. This application will be kept on file for consideration for 30 days, at which time it will expire. You are welcome to submit a new application at that time.

Personal Information

Name:
E-mail:
Address:
City:
State:
Zip Code:
Phone Number:
Are you available:

Full-Time

Part-Time

Temporary

Please describe any work schedule limitations:
Have you applied for a job with us before?

Yes

If yes, what date?
Have you been employed by us before?

Yes

If yes, state date and jobs:
Do you have relatives employed by us?

Yes

If yes, state relatives:
Have you ever been convicted of a felony, or of any crime relating to theft or dishonesty, or involving acts of violence?

Yes

If yes, please explain:

NOTE: A conviction record will not necessarily disqualify an applicant from employment. The circumstances of the conviction will be considered in relation to the nature and duties of the job applied for.

Are you a citizen of the United States, or specifically authorized to be employed in the United States?

Yes

Employment History

Name, Address, and Phone Number of Employer	Position	Duties	Wage/Salary	From	To	Reason For Leaving	May We Contact?

Education History

Name and location of High School:
Did you graduate?

Yes

School / College	Level Completed	Degree	Major Subjects

Other Skills

Describe any computer, tool, equipment or office machine skills and proficiency level:
Describe any other special skills or qualifications which may help you in the position applied for:
List all licenses or certificates held, including state, license or certificate type, date issued, and license or certificate number:
List any relevant professional or business organizations to which you belong (Optional):

Veteran Status

If you are a veteran of the armed forces of the United States, please provide the following information:

Military Branch:
Dates of Service:
Discharge Date:
Honorable Discharge?

Yes

NOTE: A less than honorable discharge will not automatically disqualify you from employment.

References

Please list three personal references, other than prior employers or relatives, whom we can contact.

Name	Phone Number	Known How Long?	Occupation

By submitting this application, I certify that the answers and information set out above are true, accurate and complete to the best of my knowledge. I acknowledge that if any answer or information is not true, accurate or complete, I may not be hired, or if hired, I may be discharged. I authorize The Alliance Group, or its agents, to investigate all statements contained in this application for employment and to investigate my character and qualifications. I authorize my prior employers, references, and others with information regarding my work or educational history or my character, to provide The Alliance Group, or its agents, with all requested information and references, and to cooperate fully with the investigation of my character and qualifications.

I understand that this application is not a contract of employment. I also acknowledge that no oral representations have been made, and that no one within The Alliance Group has the authority to make oral contracts of employment. If hired, my employment relationship with The Alliance Group is terminable at-will, with or without cause, by either myself or The Alliance Group

I also understand that any offer of employment may be conditional upon my passing a pre-employment physical examination and drug/alcohol test administered by a health care professional selected by The Alliance Group to which I hereby consent.

I understand and agree to all of the conditions and statements set forth above, and throughout this application.