EMPLOYMENT APPLICATION

Step 1 of 2

Applicant Information:
Name*
First Middle Last
If no middle name, write in N/A.
Permanent Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Position Applying For*
Desired Salary*
How did you hear about this position?*
Employment Desired:*
- Full Time
- Part Time
- Temporary/Seasonal
Desired Part-Time Hours:*
Days available to work:*
- Select All
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
Hours available to work on MONDAY:*
Hours available to work on TUESDAY:*
Hours available to work on WEDNESDAY:*
Hours available to work on THURSDAY:*
Hours available to work on FRIDAY:*
Hours available to work on SATURDAY:*
Hours available to work on SUNDAY:*
Are you 18 years of age or older?*
- Yes
- No
Are you able to provide proof of eligibility to work in the US?*
- Yes
- No
Have you ever applied to our organization before?*
- Yes
- No
Driving jobs only: Do you have a valid driver’s license?*
- Yes
- No
Training and Education:
High School or GED Information:
Name and Location Number of Years Attended Diploma or Degree Received
College Information:
Name and Location Number of Years Attended Major Diploma or Degree Received
Graduate School Information:
Name and Location Number of Years Attended Major Diploma or Degree Received
Vocational/Technical School Information:
Name and Location Number of Years Attended Major Diploma or Degree Received
Training: Including relevant rewards, scholarships, professional organizations, volunteer activities, certificates, or any other information you consider relevant to employment:
Course/Seminar Organization Content Date (s) Attended
Business References (optional)
Name Business Phone Number Relationship

Please list up to 3 references
Employment History
Employment History #1:
Name of Company
Employment Start Date
Employment End Date
Address of Company
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer's Phone Number
Position Title
Supervisor's Name
First Last
Ending Title
Describe Duties/Responsibilities
Employment History #2:
Name of Company
Employment Start Date
Employment End Date
Address of Company
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer's Phone Number
Position Title
Supervisor's Name
First Last
Ending Title
Describe Duties/Responsibilities
Employment History #3:
Name of Company
Employment Start Date
Employment End Date
Address of Company
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer's Phone Number
Position Title
Supervisor's Name
First Last
Ending Title
Describe Duties/Responsibilities

Please Read Carefully Before Signing This Form
APPLICATION AGREEMENT:

All information contained in this application is true to the best of my knowledge and belief. I understand that misrepresentation or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am selected/hired.

I authorize this organization to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to my employment or me.

Regardless of whether or not I become selected/hired by this company, I recognize that this application is not and should not be considered a contract of employment for any definite period of time. If employed, I understand that I have been hired “at-will” of the employer and my employment may be terminated at any time, with or without cause and with or without notice.
Application Agreement Consent:*
I understand and agree to the statements & policies listed in the section above titled "APPLICATION AGREEMENT".
By checking this checkbox and submitting my signature, I, the applicant, understand and agree to the statements & policies listed above in the application agreement.
Signature of Applicant:*
Date*
MM slash DD slash YYYY
Resume
Max. file size: 256 MB.
If you have a resume that you would like to submit in addition to the employment application, please upload it here.
This organization is an Equal Employment Opportunity employer. We adhere to a policy of making employment decisions without regards to race, color, religion, sex, age, disability or any other protected categories. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

We're hiring! Apply today to become a part of PAC's lifesaving team!

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION

Step 1 of 2

Applicant Information:

Training and Education:

Employment History

Please Read Carefully Before Signing This Form

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Name and Location	Number of Years Attended	Diploma or Degree Received

Name and Location	Number of Years Attended	Major	Diploma or Degree Received

Name and Location	Number of Years Attended	Major	Diploma or Degree Received

Name and Location	Number of Years Attended	Major	Diploma or Degree Received