Application for Employment

Epoch HomesApplication for Employment

Your Name (Required First, Middle, Last)

Your Email (required)

Position Applying For?

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Wage Desired?

How did you hear about this position?

When can you start work?

Current Address

Street

City

State

Zip

Phone

Are you a United States Citizen?
YesNo

If not what type of Visa do you have?

Visa Expiration Date (if applicable)

Do you have a valid driver's license?
YesNo

State of Issue?

Expiration Date?

In case of Emergency Notify?

Education

Name of High School, Location, Years Completed, Dates Attended, Major or Degree Completed

Name of College, Location, Years Completed, Dates Attended, Major or Degree Completed

Name of Business or Trade School, Location, Years Completed, Dates Attended, Major or Degree

Other Schooling: Name of Professional School, Location, Years Completed, Dates Attended, Major or Degree

Have you ever been convicted of a felony or a misdemeanor within the last five years?
YesNo

If yes, please describe:

Were you ever serious injured?
YesNo

If yes, please describe?

Tell Us About Yourself and Your Qualifications?

Use the space below to summarize additional information describing your experience and full qualifications for the position for which you are applying. You may also include any explanations you feel would be helpful in understanding other issues in your application.

List Three Personal or Professional References

Name 1

Address (Street, City, State, Zip)

Phone

Name 2

Address (Street, City, State, Zip)

Phone

Name 3

Address (Street, City, State, Zip)

Phone

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Employer/Company 1

Supervisor

Address (Street, City, State, Zip)

Position

Phone:

Employment Dates (From-To):

Salary

Reason for Leaving?

May we contact?
YesNo

List the duties you performed, skills you used or learned, positions held and promotions.

Another Work Experience

Employer/Company 2

Supervisor

Address (Street, City, State, Zip)

Position

Phone:

Employment Dates (From-To):

Salary

Reason for Leaving?

May we contact?
YesNo

List the duties you performed, skills you used or learned, positions held and promotions.

Another Work Experience

Employer/Company 3

Supervisor

Address (Street, City, State, Zip)

Position

Phone:

Employment Dates (From-To):

Salary

Reason for Leaving?

May we contact?
YesNo

List the duties you performed, skills you used or learned, positions held and promotions.

Please Read Carefully Our Application Form Waiver

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on the is application shall be grounds for dismissal at any time without any previous notice. I hereby give Epoch permission to contact schools, previous employers (unless otherwise indicated), references, and others. I further authorize the company to obtain a copy of my driving record. I hereby release Epoch from any liability as a result of such contacts, inquiries, or records in order to ascertain my qualifications and fitness for employment.

I further understand that my employment with Epoch shall be probationary for a period six months, and further that at any time during the probationary period or thereafter, my employment relationship with Epoch is terminable “at will” for any reason by either party.

Epoch is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, age or disability. We assure you that your opportunity for e mployment with Epoch depends solely on your qualifications.

Appropriate accommodations for individuals with disabilities will be provided upon request. We require eight business days notice prior to the event.

BY SUBMITTING THIS INFORMATION ONLINE I AGREE TO THE ABOVE APPLICATION FORM WAIVER.

Thank you for completing this application form and for your interest in our organization.

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