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Embed code for: GTIS 643 PM Application for Employment (8-17-16) TC
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GTIS-643 PM LLC APPLICATION FOR EMPLOYMENT
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Present Street Address
Any other names used in past?
( ) -
Social Security Number:
Name and phone number of the person to be notified in case of emergency:
Previous address (street number & name, city state, zip code)
Are you able to perform the essential functions of the position for which you are applying, either with or without reasonable accommodation?
Do you have the legal right to work and be employed in the U.S.?
(Proof of identity and legal authority to work in the U.S. is a condition of employment. For purpose of Federal Immigration Law, you will be required to provide documentary evidence of your identity and eligibility for employment in the U.S.)
Are you at least 18?
(Proof of age and work permits may be required prior to hiring.)
Name of School and Address
Have you ever worked for GTIS-643 PM LLC (the “Company”) before?
GTIS-643 PM LLC is an equal opportunity employer. The Company does not discriminate on the basis of race, color, religion, sex, pregnancy, childbirth, national origin, age, marital status, veteran status, sexual orientation, sexual identity, mental or physical disability, genetic predisposition or characteristics, or any other characteristics protected by applicable state or federal civil rights law.
What job are you applying for?
Type of position desired
Type of employment (Please check appropriate boxes)
Date available to start
Full-time or Part-time?
What interests you in the Company?
Please list all of your jobs in the past five years. (If applicable, you may list work performed on a voluntary basis. If additional pages are needed, please attach.)
Company No. 1 (present or most recent employer)
Employed (Month and Year)
Rate of Pay
Average Number of Hours
Worked Per Week:
Supervisor's Name and Position
Describe all of your significant duties:
May we contact this employer?
Reason for leaving?
Company No. 2 (present or most recent employer)
Company No. 3 (present or most recent employer)
Company No. 4 (present or most recent employer)
Please identify and explain all periods of unemployment during the last five years.
Reason for Unemployment
Do you have any other experience, training, qualifications, and skills that you feel make you especially suited for work at the Company?
Comments Is there anything else you would like us to know about you?
If employed, I agree to comply with the Company’s rules and policies, and I acknowledge that these rules and policies may be changed at any time at the discretion of the Company.
Nothing in this application or the application process creates or is intended to create or imply a contractual relationship of any kind. I understand that if hired as an employee, any such employment will be “at-will,” i.e., not for any specific time period or duration, and can be terminated for any or no reason by the Company or me at any time. I understand that no employee or representative of the Company, other than a Principal of the Company or the Human Resources Administrator, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. Further, the Principal or Human Resources Administrator, may not alter the at-will nature of the employment relationship unless the Principal or Human Resources Administrator and I both sign a written agreement that clearly and expressly specifies the intent to do so. I agree that this shall constitute a final and fully binding and integrated agreement with respect to the at-will nature of my employment relationship and that there are no oral, written, or collateral agreements regarding this issue.
I hereby affirm and certify that the information provided on this application (and accompanying resume, if any) and during the application process is true and complete to the best of my knowledge. I understand that falsified information, misrepresentation or a significant omission may disqualify me from further consideration for employment and may result in the withdrawal of any offer of employment or dismissal if discovered at a later date. I understand that any employment with the Company (if offered to me) will be contingent (among other things) upon the successful completion of all pre-employment services screening required by the Company, including but not limited to reference verification and background screens and proof of eligibility to work (or continue working) in the United States.
I hereby authorize the references listed above, as well as all other individuals whom the Company contacts, to provide the Company any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and the Company as well from any use or disclosure of such information by the Company or any of its agents, employees or representatives.
I also understand that in order to be eligible to be employed in certain positions with the Company (if offered to me), I must hold any and all certifications, registrations, and licenses as required by the Company and/or applicable law, in each case as applicable to the position for which I am applying. Failure to obtain or to maintain any such required certification, registration, or licensure may render me ineligible for employment with the Company.
Signature of Applicant
5y we contact this employer?
Nothing in this application or the application process creates or is intended to create or imply a contractual relationship of any kind. I understand