Application For Employment

American Coradius International, LLC is an equal opportunity employer. We recruit, hire, train, and promote without discrimination due to age, race, color, religion, sex, sexual orientation, martial status, national origin, citizenship, disability or an other protected by state and federal law. As a condition of employment, we reserve the right to conduct a background check on applicants prior to employment. Other conditions of employment may apply depending on the job which the applicant is seeking. Therefore, candidates are required to complete a hard copy of our application for employment after being contacted by us for an interview.
PERSONAL INFORMATION
Last Name :
M.I.
First Name :
Telephone :
E-mail :
Current Address
Street :
City :
State :
Zipcode :
Previous Address :
Do you have any restrictions, personal or otherwise, which would restrict the hours you can work? Yes No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status? Yes No (Proof of Immigration status or citizenship will be required upon employment)
Are you 18 years of age or older? Yes No
If no, state your age
Are you currently employed? Yes No
If not, how long since leaving employment?
Rate of Pay Expected :
How did you hear about us?
EMPLOYMENT DESIRED
Position applying for :
Location :
Date you can start (mm/dd/yy) :
Have you ever worked for this company before? Yes No
If so when?
EDUCATION
High School
Name :
No. of Years attended :
Did you graduate : Yes No
Degree received :
College
Name :
No. of Years attended :
Did you graduate : Yes No
Degree received :
Graduate School
Name :
No. of Years attended :
Did you graduate : Yes No
Degree received :
Technical, Business, or Other
Name :
No. of Years attended :
Did you graduate : Yes No
Degree received :
EMPLOYMENT HISTORY: (Start with your present or most recent position. Include experience in the armed forces of the U.S.)
Present Employer
Name :
Type of Business :
Address :
Phone Number :
Starting Date :
Starting Position :
Starting Earnings :
Leaving Date :
Leaving Duties :
Leaving Earnings :
Immediate Supervisor :
Reason For Termination :
First Last Employer
Name :
Type of Business :
Address :
Phone Number :
Starting Date :
Starting Position :
Starting Earnings :
Leaving Date :
Leaving Duties :
Leaving Earnings :
Immediate Supervisor :
Reason For Termination :
Second Last Employer
Name :
Type of Business :
Address :
Phone Number :
Starting Date :
Starting Position :
Starting Earnings :
Leaving Date :
Leaving Duties :
Leaving Earnings :
Immediate Supervisor :
Reason For Termination :
Third Last Employer
Name :
Type of Business :
Address :
Phone Number :
Starting Date :
Starting Position :
Starting Earnings :
Leaving Date :
Leaving Duties :
Leaving Earnings :
Immediate Supervisor :
Reason For Termination :
MISCELLANEOUS:
What Special Skills or Qualifications Do You Possess?