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Ressler Scion: Bozeman Montana's home for Scion
Employment Application
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*Your Name
First and last, please
  
*Address
City State
Zipcode
*Daytime Phone
numbers only, with area code please
 preferred
* Evening Phone
numbers only, with area code please
 preferred
* Cell Phone
numbers only, with area code please
 preferred
*E-mail preferred
*Social Security Number: 
xxx-yy-zzzz
Position
Date Of Application:  3/26/2009
*Position applied for: 
please select one
Full Time      
Part Time      
Either     
 
*How did you hear about
the position?
200 characters or less, please
Employment Eligibility
* If you are under 18 and it is required,
can you furnish a work permit? 		Yes
No
I'm older than 18
If no, please explain:  
 
* Have you ever been employed here before?  Yes No
If yes, please give dates and positions:
 
* Are you legally eligible for employment in this country? Yes No
 
Driver's license number and state 
(if driving is an essential job function):
 
* Have you ever plead "guilty" or "no contest" to,
or been convicted of a crime? 		Yes No
If yes, please provide date(s) and details:

Answering "yes" to these questions does not constitute an automatic bar
to employment. Factors such as the date of the offence, seriousness and
nature of the violation, rehabilitation and position applied for will
all be taken into account.
 
Employment History
    Please provide the following information for your past three employers,
    assignments or volunteer activities, starting with the most recent.
Previous Employment 1
From To
Employer
Address
Immediate
Supervisor/Title		 Telephone #
Your Title Salary
May We Contact? Yes    No
Reason For Leaving:
Summarize the nature of work performed and job responsibilities:
Previous Employment 2
From To
Employer
Address
Immediate
Supervisor/Title		 Telephone #
Your Title Salary
May We Contact? Yes    No
Reason For Leaving:
Summarize the nature of work performed and job responsibilities:
Previous Employment 3
From To
Employer
Address
Immediate
Supervisor/Title		 Telephone #
Your Title Salary
May We Contact? Yes    No
Reason For Leaving:
Summarize the nature of work performed and job responsibilities:
Educational Background
  Name And Location # Years
Completed		 Graduate Course of Study
High School Yes  No
College Yes  No
Other Yes  No
 
References
All are required.
Name and Relationship Telephone # Years Known
Applicant Statement
I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct.

I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

DO NOT SUBMIT UNTIL YOU HAVE
READ THE ABOVE APPLICANT STATEMENT
By submitting this application, I certify that I have read, fully
understand and accept all terms of the foregoing Applicant Statement.
   

 
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