EMPLOYMENT BACKGROUND CHECKS
Sample Employment Application Forms
Please also note that all other employment background check, drug screening, driving record and state release authorization forms are available in a PDF format file to our Automated Employment Screening Clients. All of these FCRA compliant release documents may be e-mailed to the applicants and easily completed online.
The NFIB National Federation of Independent Business is an organization that provides small businesses with a number of benefits that include:
Sample Application For Employment Application Forms
Editable versions available on the NFIB web site.
https://www.nfib.com/member-vantage/employee-management/forms/
SAMPLE APPLICATION FOR EMPLOYMENT [ Insert your company logo and address] |
[Company] is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status. |
PERSONAL: Name ________________________________________ Date __________ Address _______________________________________________________ Position Sought ____________________ ___ Full Time ___ Part Time Date Available ________ Salary Desired ________ Phone # _________ Email Address ________ Social Security Number ___________ Are you over 18 years old? __ Yes __ No Are you legally eligible for employment in the United States? __ Yes __ No EDUCATION: Please indicate education or training which you believe qualifies you for the position you are seeking. High School: No. of Yrs Completed (circle one) 1 2 3 4 School(s) ____________________ City/State ____________________ College and/or Vocational School: School(s) ____________________ City/State ____________________ Major ____________________ Degrees Earned ____________________ Other Training or Degrees: School(s) ____________________ City/State ____________________ Course _______________ Degree or Certificate Earned ______________ PROFESSIONAL LICENSE OR MEMBERSHIP: Type of License(s) Held__________________________________________ State of [State Name] License Number ___________________________________ License Expiration Date ___________________________________________ Other Professional Memberships ____________________________________ (You need not disclose membership in professional organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, marital status, veteran status or any other protected status.) |
This application for employment is good for 30 days only. Consideration for employment after 30 days requires a new application. |
SKILLS : Duties _________________________________ FT __ PT __ No. of Hrs.___ Reason for Leaving ______________________________________________ Employer ____________________ Address _________________________ Telephone _______________ Position _______________ Dates of Employment: From _____ To _____ Salary __________ Supervisor _________________ Department __________ Duties _________________________________ FT __ PT __ No. of Hrs.___ Reason for Leaving ______________________________________________ Employer ____________________ Address _________________________ Telephone _______________ Position _______________ Dates of Employment: From _____ To _____ Salary __________ Supervisor _________________ Department __________ Duties _________________________________ FT __ PT __ No. of Hrs.___ Reason for Leaving ______________________________________________ Employer ____________________ Address _________________________ Telephone _______________ Position _______________ Dates of Employment: From _____ To _____ Salary __________ Supervisor _________________ Department __________ Duties _________________________________ FT __ PT __ No. of Hrs.___ Reason for Leaving ______________________________________________ If you wish to describe additional work experience, attach the above information for each position on a separate piece of paper. Explain any gaps in work history: ___________________________________ Have you ever been discharged or asked to resign from a job? __Yes __No If yes, explain: ________________________________________________ _____________________________________________________________
REFERENCES: |
APPLICANT’S CERTIFICATION AND AGREEMENT I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize [Company] to verify their accuracy and to obtain reference information on my work performance. I hereby release [Company] from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause. Signature of Applicant ________________________ Date: __________ |
All of our reports are FCRA compliant
Our Automated Employment Screening provides an applicant controlled process that allows FCRA compliant background check forms, including Electronic Chain-Of-custody forms and releases to be completed online by the applicant.
We provide several short videos to easily acquaint you with the system.
This makes the background check process fast and easy.
Please Click or call for more information.
Disclaimer
None of the information contained in this web site should be construed as legal advice. All forms, policies, information and procedures should be reviewed by your legal counsel before being used in any way.