Allsup
Application for Employment
Anyone requiring accommodation during the application process should direct a request to the Human Resources department.

ALLSUP, INC. IS AN EQUAL OPPORTUNITY EMPLOYER.

Applicants are considered for all positions without regard to race, color, ancestry, national origin, sex, religion, gender (including pregnancy), gender identity, genetics, sexual orientation, age, marital status, military or veteran status, handicap, disability or any other legally protected status.

BE SURE YOU READ ALL INSTRUCTIONS CAREFULLY AND COMPLETE ALL SECTIONS OF THIS APPLICATION, THOROUGHLY AND ACCURATELY. YOU MAY NOT INDICATE, "SEE RESUME." PLEASE BE AWARE THAT ALL INFORMATION (e.g. DEGREE RECEIVED, PREVIOUS EMPLOYMENT, ETC.) IS SUBJECT TO VERIFICATION.

Personal Data

Last Name*
First*
Middle Initial
Mailing/Street Address*
Yrs./Mos. at Residence
City*
State*
Zip Code*
Day Telephone No. (Area Code/Number)*
Email Address
 
Other Names Used (include maiden, aliases, and nicknames)
Permanent Street Address
Yrs./Mos. at Residence
City
State
Zip Code
Evening Telephone No. (Area Code/Number)


Previous Addresses:     Please include previous TEMPORARY AND PERMANENT addresses for last ten years.
Street AddressCityState From(Date) To



Your Job Interests

Type of work desired (Please specify)
Referral source Employee name
Work location desired
Salary desired*

Please check box(es) indicating the type of employment program for which you are applying:
Type of employment desired:

If offered a position, when are you available to start?

Employment Experience Please complete all appropriate items, even if you have already provided us with a resume.

Please list your job history for the past seven years or last five employers, starting with your current or most recent position. Include any periods in which you were not employed and explain what you were doing during that time.
Current Employer Name
Street Address
City
State
Zip Code
Starting Position Title
Current Position Title
Employer Telephone
Starting Base Salary
$
per
Final Base Salary
$
per
Name of Current Supervisor
Supervisor's Position Title
 Starting Date
(mm/yyyy)
 Leaving Date
(mm/yyyy)

Is your current work performance satisfactory? May we contact your present employer now? If no, when?

Explain reason for leaving:


Please describe your responsibilities and/or accomplishments:




Education and Training Please complete all appropriate items, even if you have already provided us with a resume. Please list all schools attended.

Type of
School 		Complete Name and
Address of School 		Dates Attended Major and Minor
Fields of Study 		Graduate Type of Diploma,
Degree or
Certificate* Earned
From                    To
Mo. Yr. Mo. Yr.
*If you have obtained an equivalency diploma please indicate date and state in which obtained

U.S. Military Service   Branch:   Rank:   Duties/Training:

Professional Licenses or Certifications:

Complete if applicable:

Typing   WPM

Computer Software

Do you speak any other languages?     If yes, which one(s)?

Please include any other job related information you think would be helpful to us in considering you for employment, such as additional work experience, activities, accomplishments, volunteer work experience, etc.
(Exclude all information indicative of race, color, ancestry, national origin, sex, religion, gender (including pregnancy), gender identity, genetics, sexual orientation, age, marital status, handicap, disability, or any other legally protected status.)


General Information


Has any employer ever terminated your employment or asked you to resign?
If so, please explain what happened, the employer's name, and the date of your employment's termination.


Are you at least 18 years of age?

If you are under 18, can you furnish a work permit?

Are you presently authorized to work on a full-time basis in the United States?

Will you now or at some time in the future require sponsorship for an employer sponsored visa status?

Are you able to perform the functions of the job for which you are applying with or without reasonable accommodation?

If hired for a position requiring driving, can you provide a current drivers' license for yourself?

Have you ever previously applied to Allsup, Inc.?        Date(s) Office/Location

Have you ever been previously interviewed by Allsup, Inc.?        Date(s) Office/Location

Have you ever been employed by Allsup, Inc.?        Date(s) Office/Location
* Please indicate your name at the time(s) indicated, if different than your current name:

Are you related to anyone employed by Allsup, Inc.?        Who: Relationship:

Do you have any written agreements or other commitments to another employer or organization, which might affect your employment with Allsup, Inc.?
    If yes, please explain:


Please note: Job applicants are not obligated to disclose sealed or expunged records.
Have you ever been convicted of a felony in the last seven (7) years?    If yes, please explain and date of each conviction (In CA, exclude convictions ordered sealed, expunged, or statutorily eradicated):

Please note that a criminal record will not necessarily disqualify you from employment.

Please read the following statements carefully, as they represent matters of importance to both you and Allsup, Inc. in connection with this application for employment,
  1. I hereby certify that all information I have provided on this application is accurate and complete to the best of my knowledge. Any misrepresentation or omission of fact in my application, resume, or any other materials submitted to Allsup, Inc. may result in refusal of employment, or if employed, termination of employment whenever such misrepresentation or omission is discovered.
  2. I authorize Allsup, Inc. to verify all of the information provided by me, including but not limited to, my education, employment, and criminal background. I authorize Allsup, Inc. to obtain a credit report about me as part of the employment application process and if employed, to obtain a report for any future consideration of a promotion or transfer to a different position within the company.
  3. I authorize the references listed within this application to provide Allsup, Inc. with any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to Allsup, Inc.
  4. I understand and agree that, although management attempts to accommodate individual circumstances, including religious observance requirements, business needs may at times require overtime, shift work, a rotating work schedule, or Saturday or Sunday work.
  5. In addition, I understand and agree that this application shall be valid for a period of six (6) months. If I wish to be considered after six (6) months, I recognize that I must complete a new application for employment.
  6. If employed, I will sign an employee confidentiality agreement, in which I will agree to protect and not disclose any of Allsup, Inc.'s confidential information. Such agreement will also contain provisions which restrict my ability to compete with Allsup, Inc. or to be employed or associated with a competitive organization.
  7. I understand and agree that, if hired, my employment is for no definite period and can be terminated at any time with or without notice, with or without cause by either myself or Allsup, Inc. In the event that I am employed, I understand that regardless of the shift and job that I am first assigned, I may be required to accept a change of job or shift depending on my demonstrated skills after employment and the needs of Allsup, Inc. I understand that I must meet the health standards established by Allsup, Inc. as a condition of initial and continued employment, which may be determined by a physical examination, which may include drug and alcohol screening. I understand, also, that if employed I am required to abide by all rules, regulations and policies of Allsup, Inc.
  8. I recognize that if Allsup, Inc. hires me, then only a written employment agreement signed by Allsup, Inc.'s President/CEO (or his designees) can change my employment from one without any definite duration to employment for a specific duration. Similarly, only a written employment agreement signed by Allsup, Inc.'s President/CEO (or his designees) can put any limitations on Allsup, Inc.'s ability to terminate my employment at will if the company hires me.
  9. Upon the termination of my employment with Allsup, Inc., regardless of when, how, or why my employment ends, and regardless of whether Allsup, Inc. or I terminate my employment, I authorize Allsup, Inc. to release information about my employment history with Allsup, Inc. and release Allsup, Inc. and all of its agents from any liability for the disclosure of information about my employment history to any one or more governmental agencies, employers, or other third parties seeking information about me during my employment with Allsup, Inc.

By checking this box you agree with all above statements.

To attach resume, click browse button, select the file to attach, and then click upload resume.
The resume must be in .doc or .pdf format.



*Required Fields for Application Submission



Created on: 11/09/2009