Begin with your latest or present employer. Include all employment in the last ten
years, at least. If you need more space, request an additional sheet
Company Name, Address and Phone
How long have you lived at above address
Job Title & Supervisor's Name
Have you been reprimanded or disciplined at any
place of employment for any reason?
Have you been discharged or requested to resign
at any place of employment for any reason?
May we contact your prior employers?
Please indicate with a checkmark whether you have any of the special skills
Describe below any other job-related
skills or additional information that may be helpful to us in
considering you for employment:
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I agree that any false statement or omission in this application shall be cause for
rejection or dismissal. I hereby authorize SPSI to verify any of the information
included in this application and I release from liability those supplying such
information. If an offer of employment is made, I agree to submit to a
pre-employment physical and drug screening and I understand that any employment
offer may be conditional on the passing of such tests. I will also provide proof of
my right-to-work as required by the “Immigration Reform & Control Act of 1986”. The
use of this application form does not indicate there are positions open and does not
in any way obligate SPSI to provide employment. I understand that, should I be
employed, my employment is not for any definite period or succession of periods and
is considered any “at will” arrangement. This means I am free to terminate my
employment at any time and for any reason, as is SPSI.
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