Hiring – NEIA NFC

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. Include within the application process should you need reasonable accommodation.

Hiring Information

Position Applied For

Todays Date

Date You Can Start

How did you hear about the job?

Personal Information

First Name

Middle Name

Last Name

Home Address

City

State

Zip Code

Cell Phone

Other Phone

Email Address

Availability: Full Time, Part Time, Temporary; Describe any work schedule limitations.

Have you applied for a job with us before? (if yes, state date)

Have you been employed by us before? (if yes, state date/jobs)

Do you have relatives employed by us? (if yes, state names)

Have you ever been convicted of a felony, or of any crime relating to theft or dishonesty, or involving acts of violence? (if yes, provide details)

NOTE: A criminal 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.

Are you authorized to be employed in the United States?

NOTE: The law requires that you provide evidence and a sworn statement of your citizenship or work authorization if you are hired. Any offer of employment which you receive is contingent upon your providing the documentation and statement which we will request from you.

Prior Employment

May we contact your current employer?

List below your last three jobs, beginning with the most recent (you may omit jobs held more than five years ago).

Employer Name

Employer Address

Employer Phone

Job Title

Date Started

Date Ended

Duties

Pay $

Reason For Leaving

Employer Name

Employer Address

Employer Phone

Job Title

Date Started

Date Ended

Duties

Pay $

Reason For Leaving

Employer Name

Employer Address

Employer Phone

Job Title

Date Started

Date Ended

Duties

Pay $

Reason For Leaving

Education and Training

Name of High School

Location of High School

Did you graduate?

Please list technical or trade school, college, and post-graduate education, if any:

School/College

Level Completed

Degree/Major

School/College

Level Completed

Degree/Major

School/College

Level Completed

Degree/Major

Veteran Status

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

Military Branch

Rank at Time of Discharge

Training/Work Experience:

Other Skills

Describe any special skills including computer, tool, equipment or office machine skills and proficiency level:

List all professional affiliations and / or licenses or certificates held which are relevant to the position applied for, including state, license or certificate type, date issued, and license or certificate number:

References

Please list three references whom we can contact.

First Name

Last Name

Relationship

Phone Number

Occupation

Years Known

First Name

Last Name

Relationship

Phone Number

Occupation

Years Known

First Name

Last Name

Relationship

Phone Number

Occupation

Years Known

By initialing below, 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 Company 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 Company 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 Company has the authority to make oral contracts of employment. If hired, my employment relationship with the Company is terminable at-will, with or without cause, by either myself or the Company.
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 Company to which I hereby consent.
I understand and agree to the conditions and statements set forth above, and throughout this application.

Applicant's Initials

Today's Date

We are an equal opportunity employer. Employment opportunities are open to all qualified applicants solely based on job-related experience, knowledge, skills and abilities. Qualified applicants are considered for open positions for which they apply and for advancement without regard to race, color, religion, gender, sexual orientation, national origin, age, marital status, or the presence of a medical condition or disability. The Company complies with all applicable federal, state and local laws of equal employment opportunity. Advancement is based entirely on an individual's demonstrated performance, job-related knowledge, skills, and ability.

This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.