Are you employed now?YesNo
If so may we contact your present employer?
Ever applied to this company before? YesNo Where and When:
General subjects of special study or research work:
I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
Authorization will include credit and criminal checks for individuals having access to keys and money.
I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any prior notice.
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