Job Application

Full Name:
First
Middle
Last
Date:
Address:
Street Address
Appartment/Unit #
City
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State
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Date Available:
Social Security No.:
Desired Salary:
Position Desired:
Referral Source: 
Are you a citizen of the United States?
If no, are you authorized to work in the U.S?
Have you ever applied / worked for this company?
If yes, when?
High School:
Address:
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Did you graduate?
Diploma:
College:
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Did you graduate?
Degree:
Other:
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From:
To:
Did you graduate?
Degree:

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Please list three professional references
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Full Name:
Relationship:
Company:
Phone:
Address:

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Full Name:
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                                                                                             PREVIOUS EMPLOYMENT                                                                                  

Company:
Phone:
Address:
Job Title:
Starting Salary:
Supervisor:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for reference?

                                                                                                                                   .                                                                                  

Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for reference?

                                                                                             DISCLAIMER AND SIGNATURE                                                                          

I certify that the information contained in this application is true and correct to the best of my knowledge and understand that any false or misleading statement or omission, whenever discovered, regarding this application is a reason for disqualification from further consideration or for dismissal from employment.

If employed by the company, I agree to conform to the guidelines and policies of the Company, and understand that MY EMPLOYMENT IS COMPLETELY VOLUNTARY AND CAN BE TERMINATED AT ANY TIME AND FOR ANY REASON BY THE COMPANY OR MYSELF WITH OR WITHOUT NOTICE.
I understand and agree that all conditions of my employment and such agreements must be in writing and signed by the President or Human Resources Representative. Any oral representations to the contrary are void.

I consent to and authorize the Company to make a full and complete investigation of my personal or employment history and authorize any former employer, person, firm, corporation, school, credit agency, government agency or other entity to provide the Company with any information of any sort (including fact or opinion) they may have regarding me. In consideration of the Company's review of this application, I release the Company and all providers of any information from any liability as a result of furnishing and receiving this information. I understand and agree that if offered employment by the Company, any such employment offer shall be dependent upon the receipt of satisfactory references as determined by the Company, I further authorize the Company to provide in good faith, information regarding my employment to any potential or future employer and release and waive any claims against the Company for communicating any such information in good faith to a potential or future employer

I understand and agree that an investigative consumer report may be made concerning any character, reputation, personal characteristics and mode of living. I hereby consent to and authorize that such a report be made which may include information regarding my credit, Information as to the nature and scope of this report may be obtained upon written request.
The Company may inquire into and consider any criminal conviction record that you have after it makes you any conditional offer of employment. The Company may withdraw any conditional offer if your criminal conviction record bears a rational relationship to the duties or responsibilities of the position for which you are applying. Any criminal conviction record that is more than 10 years old or that involves certain family court matters will not be considered.

In the event I am dissatisfied or disagree with any action taken by the Company, I agree to submit the matter to the Company’s Grievance and Arbitration Procedure for final and binding arbitration and further agree that I will not initiate a lawsuit on any matter that could be submitted to the Company's Grievance and Arbitration Procedure. In consideration for the company's examination and investigation of my employment application and in order to promptly resolve any legal dispute I may have with the Company regarding my recruitment, employment, employment benefits, or separation of employment including but not limited to any and all employment discrimination and claims brought under federal and state laws. I agree to submit any and all claims to binding Arbitration pursuant to the Federal Arbitration Act in accordance with the procedures of the American Arbitration Association then in effect resolving such disputes.
I understand and agree that all of the foregoing terms and conditions will become part of my employment relationship with the Company if Marsico, LTD employs me.
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                                                                             AN EQUAL OPPORTUNITY EMPLOYER                                                                               

Thank you for your interest in Marisco, LTD. You must properly complete ALL portions of this employment application to be considered for employment at Marisco, LTD. Marisco, LTD. is an equal opportunity employer. Applications are considered for all positions without regards to age, sex, race, religion, color, national origin, ancestry, marital status, disability, arrest and court record, sexual orientation, military service or other protected categories in accordance with state and federal laws. This application is considered current for 90 days. If you wish to be considered for employment subsequent to this period, it will be necessary to fill out a new application.

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