Employment Application

All files with a * are required.

About Yourself

Position desired: *
Salary expectation: *
When will you be able to begin work?
Full-time or part-time: *
Full-time Part-time
If part-time, how many hours per week?
Full Name: *
Do you have a Social Security Number # ?
Yes No
Street Address: *
City, State, Zip: *
Home Phone: *
Other Phone: *
E-mail Address: *
How did you hear about us? *
Have you ever applied for employment with us? Yes No
When?
Employed with us before? * Yes No
When?
Have you ever visited The Marsh? If so, tell us about the experience.
What compelled you to apply to The Marsh?
What does it mean to you when you think about providing excellent customer service? *

Education

Graduate School
 - Name & Location
- Course of Study
- # Years Completed
- Did you Graduate?
- Degree or Diploma
College/Vocational
 - Name & Location
- Course of Study
- # Years Completed
- Did you Graduate?
- Degree or Diploma
High School
 - Name & Location *
- Course of Study *
- # Years Completed *
- Did you Graduate? *
- Degree or Diploma *
Please list other training, apprenticeship, skills, and seminars that would apply to the position desired:

Professional Information

License, certification, or registration
 - State Issued
- Current Number
- Expiration Date
License, certification, or registration
 - State Issued
- Current Number
- Expiration Date
License, certification, or registration
 - State Issued
- Current Number
- Expiration Date
List skills and abilities noted such as typing (wpm), shorthand, word processing, transcription, personal computer, software packages, LAN, WAN, internet etc.

Employment

Past Employer #1
(most recent)
 - Company name *
- Address *
- Telephone *
- Supervisor name *
- Position title *
- Date job began *
- Date job ended *
- Hours worked per wk*
- May we Contact?
- Reason for Leaving
Description of job duties (include skills that you could apply to The Marsh)
Past Employer #2
 - Company name *
- Address *
- Telephone *
- Supervisor name *
- Position title *
- Date job began *
- Date job ended *
- Hours worked per wk*
- May we Contact?
- Reason for Leaving
Description of job duties (include skills that you could apply to The Marsh)
Past Employer #3
 - Company name
- Address
- Telephone
- Supervisor name
- Position title
- Date job began
- Date job ended
- Hours worked per wk
- May we Contact?
- Reason for Leaving
Description of job duties (include skills that you could apply to The Marsh)
Past Employer #4
 - Company name
- Address
- Telephone
- Supervisor name
- Position title
- Date job began
- Date job ended
- Hours worked per wk
- May we Contact?
- Reason for Leaving
Description of job duties (include skills that you could apply to The Marsh)

Professional Resources

Reference #1
 - Name
- Title
- Business Address
- Telephone
Reference #2
 - Name
- Title
- Business Address
- Telephone
Reference #3
 - Name
- Title
- Business Address
- Telephone

Additional Questions

Are you legally eligible for employment in the United States? *
 Yes No
Proof of U.S. citizenship will be required upon employment.
Are you 18 years of age or older? *
 Yes No
If not, how old are you?
Have you ever been convicted of any crime? (Convictions of a crime may not automatically remove you from consideration.)*
 Yes No
If so, gives date(s), a detailed explanation of the incident(s), and the outcome(s) or write "not applicable".*
Upload your resume here:

Applicants Statement

By my signature below, I certify that the information in this employment application (and accompanying resume or documentation, if any) and interview(s) is true, accurately represented, and complete. I understand that giving false information or omitting vital and requested information could result in disqualifying me for employment or my subsequent dismissal, if employed. I understand and agree that my employment may be contingent upon successful completion of a criminal background investigation as required by law. The existence of a criminal record may not constitute an automatic bar from consideration for my employment.

In addition, I authorize investigations of all statements and facts contained in this application and other related matters as may be necessary in making an employment decision. I hereby release from all liability of responsibility of all present or previous employers, schools, or any persons making such disclosures.

If hired, my employment is for no definite period and may be terminated without prior notice, regardless of the date of payment of my wages and salary. I understand that I have the right to terminate my employment at any time for any reason or no reason, and the employer retains the same right regarding the discontinuation of my employment.

I understand my application for employment shall be active for a period of time not to exceed six months.

I hereby acknowledge that I have read and understand the foregoing.

Yes No