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Employment Application

Employment Application

    APPLICANT INFORMATION

    Are you a citizen of the United States?*YesNo

    If no, are you authorized to work in the U.S.?*YesNoN/A

    Have you ever worked for this company?*YesNo

    Have you ever been convicted of a felony?*YesNo

    EDUCATION

    Did you graduate?*YesNo

    Did you graduate?YesNo

    Did you graduate?YesNo

    REFERENCES

    Please list three professional references.

    Reference 1

    Reference 2

    Reference 3

    PREVIOUS EMPLOYMENT

    Previous Employment 1

    May we contact your previous supervisor for a reference?YesNo

    Previous Employment 2

    May we contact your previous supervisor for a reference?YesNo

    Previous Employment 3

    May we contact your previous supervisor for a reference?YesNo

    MILITARY SERVICE

    DISCLAIMER AND SIGNATURE

    I certify that my answers are true and complete to the best of my knowledge.
    If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

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    Clinton Place provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.