Employment Application

Step 1 of 8

College/Technical/Business School:
Name of Institution Attended:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attended From:
MM slash DD slash YYYY

mm/dd/yyyy
Attended To:
MM slash DD slash YYYY

mm/dd/yyyy
Major
Minor
Did you Graduate?
- Yes
- No
Do you receive a degree?
- Yes
- No
What degree did you receive (if you received one)?

Graduate School
Name of Institution Attended:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attended From:
MM slash DD slash YYYY

mm/dd/yyyy
Attended To:
MM slash DD slash YYYY

mm/dd/yyyy
Major
Minor
Did you Graduate?
- Yes
- No
Do you receive a degree?
- Yes
- No
What degree did you receive (if you received one)?
Are you still in school?
- Yes
- No
If yes, how many courses are you taking?
What is your course of study?
Number of credits to date:

References
Please list three professional references:
Name*
Relationship:*
Company:
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name*
Relationship:*
Company:
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name*
Relationship:*
Company:
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employment History
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor's Name:
Job Title:
Starting Pay Rate:
Ending Pay Rate:
Responsibilities:
Employed From:
MM slash DD slash YYYY

mm/dd/yyyy
Employed To:
MM slash DD slash YYYY

mm/dd/yyyy
May we contact this employer?
- Yes
- No
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor's Name:
Job Title:
Starting Pay Rate:
Ending Pay Rate:
Responsibilities:
Employed From:
MM slash DD slash YYYY

mm/dd/yyyy
Employed To:
MM slash DD slash YYYY

mm/dd/yyyy
Reason for leaving?
May we contact this employer?
- Yes
- No
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor's Name:
Job Title:
Starting Pay Rate:
Ending Pay Rate:
Responsibilities:
Employed From:
MM slash DD slash YYYY

mm/dd/yyyy
Employed To:
MM slash DD slash YYYY

mm/dd/yyyy
Reason for leaving?
May we contact this employer?
- Yes
- No
Please state any additional information you feel may be helpful to us in considering your application (please include special skills):

Applicant's Statement and Conditions of Employment
Consent*
I acknowledge I have read and understanding I have read the Statement and Conditions of Employment below.
Please read before signing. If you have any questions regarding this statement, please ask them on any interviewer before signing.

As a condition of my employment, I accept the principle that the welfare of the organization depends upon the conduct and honestly of the staff and upon the trust and confidence of the public. Our clients rightly expect honesty, security, and confidentiality in their affairs. I therefore agree to the following:

1. I certify that the answers given my me in this employment application are true, correct and complete. I agree that the company shall not be liable, in any respect, if my employment is terminated because of misstatements or pertinent omissions made by me on this application.

2. I understand that a background check involving information concerning my character, employment history, and police record will be obtained after employment and based on those findings, may cause any offer of employment to be withdrawn.

3. I understand that any offer of employment is contingent upon passing the company's prescribed drug and alcohol screening. I agree as a condition of my employment (should I be employed by SBAWP) to submit to a drug or alcohol test when required.

4. I understand and acknowledge that my employment relationship with this Association is of an "At Will" nature, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time, with or without notice, with or without cause. It is further understood that this "At Will" employment relationship may not be changed by any written document or by verbal agreement unless such change is specifically acknowledged in writing by the Executive Director or President of the Board of Directors of the Association.

5. I understand that SBAWP retains the right to amend, modify, add or delete any or all policies at tils sole and absolute discretion.

6. I understand that past employers/educational institutions and/or military may be contacted for references.

By putting my name below I hereby acknowledge that I have read the above statement and understand the same.
Name*

This will count as your signature
Date
MM slash DD slash YYYY

mm/dd/yyyy
CAPTCHA

Employment Application

EDUCATION

College/Technical/Business School:

Graduate School

Military History

References

Employment History

Applicant's Statement and Conditions of Employment

3000 Stonewood Drive, Suite 100
WEXFORD, PA 15090

724-934-9600
[email protected]

Employment Application​

Step 1 of 8

EDUCATION

College/Technical/Business School:

Graduate School

Military History

References

Employment History

Applicant's Statement and Conditions of Employment

3000 Stonewood Drive, Suite 100WEXFORD, PA 15090 724-934-9600[email protected]

Employment Application

3000 Stonewood Drive, Suite 100
WEXFORD, PA 15090

724-934-9600
[email protected]