Employment Opportunities with Strategic Connections

Personal Information

Full Name*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Email Address*

Phone Number*

How You Were Referred*

Position of Interest*

Type of Employment*

Full Time
Part Time
Temporary
Seasonal

Salary Expectations*

Date You Can Start*

Do you have a current, valid NC Driver’s License?*

Yes
No

If No, explain:*

Worked Here Before?*

Yes
No

18 or Older?*

Yes
No

United States Citizen?*

Yes
No

Ever Been Convicted of a Felony?*

Yes
No

Answering "yes" to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.

Please explain Felony*

Summarize Your Special Skills or Qualifications*

Previous Employment - Most Recent

Name of Company*

Positions Held*

Start Date*

End Date*

Address of Employer*

Street Address City State / Province / Region ZIP / Postal Code

Phone Number*

Supervisor*

Title of Supervisor*

Your Responsibilities*

Starting Salary*

Ending Salary*

Reason For Leaving*

May We Contact This Employer for Reference?*

Yes
No

Previous Employment

Please List Previous Employers, Dates and Job Duties

Employer*

From-To Dates*

Job Duties Performed*

OPTIONAL Name/Phone of Contact for Reference

Previous Employment

Please List Previous Employers, Dates and Job Duties

Employer*

From-To Dates*

Job Duties Performed*

OPTIONAL Name/Phone of Contact for Reference

* Applicant's Statement - Authorization *

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.*

I Agree To The Authorization

Job Application

Personal Information

Previous Employment - Most Recent

Previous Employment

Previous Employment

*** Applicant's Statement - Authorization ***

* Applicant's Statement - Authorization *