Employment Application - Executive Image Building Services, Inc.

It is the policy and intent Executive Image to provide equal opportunity in employment for all persons. This policy prohibits discrimination on the basis of race, color, religion, national origin, political affiliation, disability, marital status, sex, sexual orientation, or age. This policy applies to all phases of employment. No question on this application is intended to secure information to be used for such discrimination.

Personal Information

Full Name *

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Are you 18 or older? *YesNo

Are you either a United States citizen or an Alien authorized to work in the United States? *YesNo

Have you ever been employed by an Executive Image company? *YesNo

Employment Desired

How did you hear about us? *

Position Desired

Desired Pay

Date Available *

Month *

Day *

Year *

Do you prefer *

How many hours per week would you like to work?

Please describe your availability *

Can you work weekends? *YesNo

Have you ever been fired from a job? *YesNo

Work/Professional References

Please list two (2) Work or Professional References that we may contact. Reference #1

First Name *

Last Name *

Company or Relationship *

Phone *

Reference #2

First Name *

Last Name *

Company or Relationship *

Phone *

Please list two (2) Personal References that we may contact.

Personal Reference #1

First Name *

Last Name *

Company or Relationship *

Phone *

Personal Reference #2

First Name *

Last Name *

Company or Relationship *

Phone *

Signature *Sign by typing your Full Name

Feel free to attach a cover letter

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Feel free to attach a résumé

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