Employment Application

Job Information

Position(s) applied for:

How did you learn about us?*

Personal Information

Name*

First Middle Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Home Phone*

Email*

Cell Phone*

Employment Details

If under 18, can you provide required proof of eligibility to work?*

N/A
No
Yes

Have you ever filed an application with us before?*

No
Yes

If yes, give date:

Have you ever been employed with us before?*

No
Yes

If yes, give date:

Are you currently employed?*

No
Yes

May we contact your present employer?*

No
Yes

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?*

No
Yes

On what date would you be available for work?

Are you available to work:*

Full Time
Part Time
Shift Work
Temporary

Are you currently on "lay-off" status or subject to recall?*

No
Yes

Can you travel if a job requires it?*

No
Yes

Have you been convicted of a felony in the past 7 years?*

No
Yes

If yes, please explain:

Resume

Upload Resume:(*.pdf files only please)

Education

Elementary School

Name of School*

Course of Study*

Years Completed*

Diploma/Degree*

High School

Name of School*

Course of Study*

Years Completed*

Diploma/Degree*

College

Name of School*

Course of Study*

Years Completed*

Diploma/Degree*

Graduate School

Name of School*

Course of Study*

Years Completed*

Diploma/Degree*

Other

Name of School*

Course of Study*

Years Completed*

Diploma/Degree*

Describe any specialized training, apprecticeship, skills, and extra-curricular activities:

Describe any job-related training received in the United States Military (if applicable):

Employment Experience

Employment Info

Employer*

Address*

Phone*

Title*

Supervisor*

Reason for Leaving*

From Date*

To Date*

Start Salary*

End Salary*

Duties*

Are you able to provide additional employment (we suggest at least two)?*

Yes
Not Applicable

Employment Info

Employer*

Address*

Phone*

Title*

Supervisor*

Reason for Leaving*

From Date*

To Date*

Start Salary*

End Salary*

Duties*

Are you able to provide additional employment?*

Yes
Not Applicable

Employment Info

Employer*

Address*

Phone*

Title*

Supervisor*

Reason for Leaving*

From Date*

To Date*

Start Salary*

End Salary*

Duties*

Are you able to provide additional employment?*

Yes
Not Applicable

Employment Info

Employer*

Address*

Phone*

Title*

Supervisor*

Reason for Leaving*

From Date*

To Date*

Start Salary*

End Salary*

Duties*

Additional Information

Summarize special job-related skills and qualifications acquired from employment or other experience:

State any additional information you feel may be helpful to us in considering your application:

References

Reference 1 Name*

Reference phone*

Address*

Reference 2 Name*

Reference phone*

Address*

Reference 3 Name*

Reference phone*

Address*

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Please place your digital signature in the box provided below:

Signature*

Date*

Click the submit button below to send this application to DBS for review.

You will be contacted within 1-2 weeks with additional information.

DBS Rescue

Employment Application

Job Information

Personal Information

Employment Details

Resume

Education

Elementary School

High School

College

Graduate School

Other

Employment Experience

Employment Info

Employment Info

Employment Info

Employment Info

Additional Information

References

Applicant's Statement

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