Employee Application Form

This Employment Application is for an Individual ISN Company

Personal Information:

First Name:

Middle Name:

Last Name:

Address:

City:

State:

Zip Code:

Home Phone Number:

Cell/Pager Number:

Date Available To Start:

Position Applied For:

Salary Desired:

Are you at least 18 years old?:

Yes No

If under 18 do you have a work permit?:

Yes No

Are you employed now?:

Yes No

May we contact your present employer?:

Yes No

Have you ever been convicted of a felony?:

Yes No

If yes, please explain (a conviction record will not necessarily be a bar to employment.):

Are you available to work:

Full Time Part Time Shift Work Temporary

DayFromTo

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

This job requires traveling to different job sites.
Are you able to travel?

Yes No

Do you have reliable transportation?

Yes No

Are you legally eligible for employment in the United States?
(If yes, proof is required)

Yes No

Can you perform the essential functions of the job for which you are applying?

Yes No

Work History Starting With Most Recent Employer:

Company Name:

Address:

City:

State:

Zip Code:

Phone:

Job Title:

Supervisor's Name:

Dates Employed:FromTo

Hourly Rate Salary:StartingFinal

List of Duties:

Reason for leaving:

Company Name:

Address:

City:

State:

Zip Code:

Phone:

Job Title:

Supervisor's Name:

Dates Employed:FromTo

Hourly Rate Salary:StartingFinal

List of Duties:

Reason for leaving:

Applicant's Statement:

I certify that the answers given herein are true and correct to the best of my knowledge. I understand that falsification of information provided in the hiring process will be grounds for termination in the event I am hired by one of the ISN companies.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

I understand that this application is not intended to be a contract of employment and does not create any express or implied contractual rights of employment. Employment with an ISN company is on an at-will basis. This means that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the discretion of either an ISN company or myself. I understand that no management official or other employee of an ISN company, other than the president has any authority to enter into any agreement contrary to the foregoing, unless the agreement is in specific written format and signed by the president of an ISN company.

I accept the terms stated above: