Online Job Application

EMPLOYMENT:
Begin with your current or most recent employment. Include all periods of military service. If you have no prior work experience, please list school and personal references in this section.
Name of Company:
Address
Street Address: Address Line 2: City: State / Province / Region: ZIP / Postal Code:
Job Title:
Dates Employed:
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Reason for Leaving:
Name of Company:
Address
Street Address: Address Line 2: City: State / Province / Region: ZIP / Postal Code:
Job Title:
Dates Employed:
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Reason for Leaving:
Name of Company:
Address
Street Address: Address Line 2: City: State / Province / Region: ZIP / Postal Code:
Job Title:
Dates Employed:
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Reason for Leaving:

REFERENCES:
Reference #1*
First: Last:
Name of Company:*
Job Title:*
Phone Number:*
Email:*
Reference #2*
First: Last:
Name of Company:*
Job Title:*
Phone Number:*
Email:*
Reference #3
First: Last:
Name of Company:
Job Title:
Phone Number:
Email:

Applicant's Statement:*
- I understand that any employment offer will be contingent upon the center/Athena affiliated company's receipt of satisfactory references, a satisfactory physical examination, a criminal background check and to my submitting documentary proof of my identity and eligibility to legally work in the United States.
*
- I understand that if employed, I will be an “employee-at-will”, which means that both the center/Athena affiliated company and I can terminate my employment at any time, for any reason consistent with applicable state and federal law.
*
- I understand that this application is not a contract of employment.
*
- I understand that the center/Athena affiliated company may thoroughly investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. I authorize all individuals, schools, and employers named therein, except my current employer if so noted, to provide any information requested about me, and I release all parties involved from any and all liability arising out of the release of this information.
*
- I certify that I am under no contractual obligations that would preclude me from working for the center/Athena affiliated company.
*
- I certify that all the statements herein are true and understand that any falsification or material omissions may result in refusal of employment, or, if hired, may result in termination of employment.
*
- I hereby release from all liability, the company or person(s) listed as references, and authorize to release all information regarding my employment with them.
*
- I further certify that my typed name below shall serve as my written signature.
Applicant's Name (Signature):
Date:
MM slash DD slash YYYY
Attached resume and/or cover letter
Accepted file types: pdf, doc, docx, Max. file size: 2 MB.

Step 1 of 7

EDUCATION:

EMPLOYMENT:

REFERENCES: