CONTACT INFORMATION
First Name:
*
Last Name
*
Middle Name
Address
*
City
State
Zip
*
Phone
*
Mobile Phone
*
Fax
E-mail
*
 
PERSONAL INFORMATION
If Driving is Required For Your Position, Do You Have A Valid Drivers License?
No
Yes
Are you able, at the time of employment, to submit verification of your legal right to work in the US?(Verification and completion of Form I-9 must be submitted no later than three business days after date of hire?
No
Yes
Have You Ever Been Convicted of a Felony?
No
Yes
Explanation
 
JOB INFORMATION
Start Date
*
Attach Resume
 
Desired Salary:
Referred By:
 
EXPERIENCE & REFERENCES
Are You Employed Now?
No
Yes
May We Contact Your Current Employer?
No
Yes
 
EDUCATION
High School
College:
Trade School:
 
MOST RECENT EMPLOYER
Employer Name
Address
Contact/Phone
Dates
Salary
Reason For Leaving
 
REFERENCES
Reference 1 Name:
Address
Phone
 
Reference 2 Name
Address
Phone
 
Reference 3 Name
Address
Phone
 
Additional Information To Be Considered
Wise Installation
Applicant Data Survey
(Encuesta sobre los datos del Aspirante)
To be completed by Applicant - Not for Interview Purpose
(Completato por el Aspirante - No es parte de la entrevista)
Wise Installation is an equal opportunity employer and does not discriminate on the basis of race, color, religion, national origin, ancestry, physical and/or mental disability, medical condition, marital status, gender, pregnancy, age, veteran status or any other status protected under state or federal statutes relating to equal opportunity in employment.
(Wise Installation es un empleador de oportunidad iguales y no discrimina por bases de la raza, color, religión, original de otra nación, antepaso, incapacidad mental y/o fisica, condición medica, matrimonial, género, embarazo, edad, veterano, o par otras protecciones estatal o federal aplicable a las leyes de oportunidadigual)
The following survey is for statistical purposes only and is VOLUNTARY. This information will not be used in the hiring process. If you do not wish to complete this survey, check the "Decline" line.
(Las siguientes preguntas son para recoger estadisticas solamente y es VOLUNTARIO. Esta información no se usará para emplearlo. Si usted no desea completar esto, marque "Rechazo").
This information will be maintained separate from your application and will be available only to the Wise Installation Human Resources Department
(Esta informacion se mantendrá separado de su applicacion y es solamente usada por nuestro departamento de Servicios Humanos-Human Resources en Inglés)
Please check one (Indique)
Male (Hombre)
Female (Mujer)
 
Race/Ethnic Group (Raza/etnico):
Hispanic (Hispanico)
Black (Negro)
White (Blanco)
American Indian (Americano Nativo)
Asian (Asiatico)
Other (Otro)
 
 
Please check if any of the following are applicable (Indique si alguno de estos es aplicable):
Veteran Disabled
Yes
No
Vietnam Veteran
Yes
No
Other Veteran
Yes
No
Armed Forces Service Medal
Yes
No
 
Decline to complete Survey (Rechazo completar Estos Datos)
AUTHORIZATION I certify that the facts contained in this application are the truth and complete to the best of my knowledge, and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein, including criminal background check, and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing unless it is in writing and signed by an authroized company representative. I ALSO UNDERSTAND THAT THIS IS A DRUG FREE WORKPLACE AND THAT I WILL WILLINGLY TAKE A DRUG TEST IF REQUIRED.
 

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