Application for Employment - NVS Corporate Services

Step 1 of 4

25%

Position Applied For:*

Name*

First Middle Last

Email*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Mobile Phone

Work Phone

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.)*

Yes

What employment level are you looking for?*

(check all that apply)

Full-Time

Part-Time

Temporary

What hours are you available to work?*

Are you willing to work*

(check all that apply)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Are you willing to work*

(check all that apply)

Day

Evening

Are you willing to take a drug screen/physical exam?*

Yes

Have you ever been convicted of a felony?*

Yes

If yes, please describe conditions:*

Employment Desired

How did you hear of this opening?

Have you ever applied for employment here?*

Yes

If yes, when?

Have you ever been employed by this company?*

Yes

If yes, when?

Are you presently employed?*

Yes

May we contact your present employer?*

Yes

Will you continue with your present employer if offered a position with this company?*

Yes

Are you willing to travel?*

Yes

What percent?*

Date you can start*

Desired starting salary*

Please list applicable skills*

Education

High School

Year(s)

Major

Degree

College

Year(s)

Major

Degree

College

Year(s)

Major

Degree

Post-College

Year(s)

Major

Degree

Other Training

Year(s)

Major

Degree

In addition to your work history, are there are other skills, qualifications, or experience that we should consider?*

Please list any scholastic honors received and offices held in school or employers.*

Are you planning to continue your studies?*

Yes

Where and what courses of study?

Employment History

Start with most recent employer

Company Name	Date Started	Date Ended	Name of Supervisor	Actions

There are no employment histories.

Maximum number of employment histories reached.

Professional References

List three professional references, not related to you, who have known you for more than one year.

Name	Phone	Years Known	Actions

There are no professional references.

Maximum number of professional references reached.

Emergency Contact

In case of emergency, please notify:

Name

First Last

Phone

Address

Consent*

I certify that all information provided by me on this application is true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would alter the integrity of this application.

I authorize my previous employers, schools, or persons listed as references to give any information regarding employment or educational record. I agree that this company and my previous employers will not be held liable in any respect if a job offer is not extended, or is withdrawn, or employment is terminated because of false statements, omissions, or answers made by myself on this application. In the event of any employment with this company, I will comply with all rules and regulations as set by the company in any communication distributed to the employees.

In compliance with the Immigration Reform and Control Act of 1986, I understand that I am required to provide approved documentation to the company that verifies my right to work in the United States on the first day of employment. I have received from the company a list of the approved documents that are required.

I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I hereby acknowledge that I have read and understand the above statements.

I have read the above