Columbus
Educational Services
Recruitment, retention, results. Guaranteed.
1012 West Ninth Avenue
King of Prussia, PA 19406
800-229-5116
www.columbused.com

Career Opportunities and Application

     
 
Application for Employment

It is basic employment policy of THE COLUMBUS ORGANIZATION to insure that all applicants for employment will be considered without regard race, color, age, creed, sex, national origin, marital, familial or veteran status, or handicap.

 
Position(s) applied for
Date
Referral Source
Advertisement  
Employee- Referral Name
Relative  
Walk-in  
Other  
 
Name
Address
City
State
Zip
Social Security #
Email
Telephone #
Occupational/Field of Licensure (if applicable)
Professional License#/State (if applicable)
Is your License active and in good standing?
Has there any disciplinary action against your license? If so, Please explain.
If necessary, best time to call you at home is:
If you are under 18, and it is required, can you furnish a work permit?
yes   No
Are you legally eligible for employment in this country?
yes   No
When are you available for work?
Will you travel if job requires it?
yes   No
Are you able to meet the attendance requirements of the position?
yes   No
Have you ever pled (guilty) or "no-contest" to, or been convicted of a crime?
yes   No

If yes, please provide date(s) and details

Driver's License number
 State

Education

Show all formal education including U.S. military school. Please attach a copy of your resume and make references to the information set forth therein.

High School Last Attended:
Dates Attended
From/To		 Graduated Degree Received Major/Minor
College or University
Dates Attended
From/To		 Graduated Degree Received Major/Minor
Other
Dates Attended
From/To		 Graduated Degree Received Major/Minor

Employment History

List all employment, including previous THE COLUMBUS ORGANIZATION employment and U.S. military services, starting with present employer. Please attach a copy of your resume and make references to the information set forth therein.

Employer's Name and Address
Dates Employed:
Telephone:
Type of Business
Starting Job Title/Final Job Title
Immediate Supervisor and Title
Major Duties Performed
Reason for Leaving
Salary
 Bonus
 Commissions
 Other Compensation
Employer's Name and Address
Dated Employed:
Telephone:
Type of Business
Starting Job Title/Final Job Title
Immediate Supervisor and Title
Major Duties Performed
Reason for Leaving
Salary
 Bonus
 Commissions
 Other Compensation
Employer's Name and Address
Dated Employed:
Telephone:
Type of Business
Starting Job Title/Final Job Title
Immediate Supervisor and Title
Major Duties Performed
Reason for Leaving
Salary
 Bonus
 Commissions
 Other Compensation

Professional References

Name and Address:
Relationship to Reference:
Co-Worker Supervisor Other
Telephone
Home: Work:
May We Contact for Reference?
Yes No Later

Name and Address:
Relationship to Reference:
Co-Worker Supervisor Other
Telephone
Home: Work:
May We Contact for Reference?
Yes No Later

Name and Address:
Relationship to Reference:
Co-Worker Supervisor Other
Telephone
Home: Work:
May We Contact for Reference?
Yes No Later

Name and Address:
Relationship to Reference:
Co-Worker Supervisor Other
Telephone
Home: Work:
May We Contact for Reference?
Yes No Later
 

Employment Inquiry Release

I hereby authorized the potential employer to contact, obtain and verify the accuracy of information contained in this application from all previous employers, educational institutions and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering and using such information to make employment decisions and all other persons or organizations fro providing such information.

I certify that all information, including, but not limited to the information set forth in my resume, that I have provided in order to apply for and secure work with THE COLUMBUS ORGANIZATION is true, complete and correct.

I understand that any information provided by me, including all information found on my resume, that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer’s service, whenever it is discovered.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contact for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an 1-9 Form this regard.

Do not check the below box until you have read the above Application Statement
I certify that I have read, fully understand and accept all terms of the forgoing Applicant Statement.
 
 
 
     
 
Copyright 2006. Columbus Educational Services