Application

We appreciate your interest in employment with our organization. Thank you for taking the time to complete this application.
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PERSONAL
Last Name (required)
First Name (required)
Email (required)
Phone number (required)
Address (required)
City (required)
State (required)
ZIP Code (required)
Are you legally eligible for employment in the USA? (required) . If hired, you are required to submit proof of your eligibility to work in the USA.
Are you eighteen or over? (required) If no, hire is subject to verification that you are of minimum legal age.
Position(s) applied for:
Shift applied for:
Have you previously been employed by NVIC?
If yes, when?
If your application is considered favorably, on what date will you be available for work?
Please list your job related experiences, skills, or qualifications which will be of special benefit in the job for which you are applying.
Referred to NVIC by:
Relationship:
EMPLOYMENT HISTORY
Please list all employers, including military service; students should list all summer and part-time jobs. Begin with your most recent employment. Include explanations of any gaps in employment.
EMPLOYER 1 (required)
Name and address of company and type of business.
Describe the work you did
From
To
Start wage
End wage
Telephone
Supervisor
Reason for leaving
EMPLOYER 2
Name and address of company and type of business.
Describe the work you did
From
To
Start wage
End wage
Telephone
Supervisor
Reason for leaving
EMPLOYER 3
Name and address of company and type of business.
Describe the work you did
From
To
Start wage
End wage
Telephone
Supervisor
Reason for leaving
EMPLOYER 4
Name and address of company and type of business.
Describe the work you did
From
To
Start wage
End wage
Telephone
Supervisor
Reason for leaving
EMPLOYER 5
Name and address of company and type of business.
Describe the work you did
From
To
Start wage
End wage
Telephone
Supervisor
Reason for leaving
EMPLOYER 6
Name and address of company and type of business.
Describe the work you did
From
To
Start wage
End wage
Telephone
Supervisor
Reason for leaving
Please mark the employees we may contact. Employer 1Employer 2Employer 3Employer 4Employer 5Employer 6
EDUCATION
Name and address of high school
Indicate last year completed
Did you graduate?
Name and address of college
Indicate last year completed
Did you graduate?
Name and address of other education
Indicate last year completed
Did you graduate?
PERSONAL REFERENCES
No former employers or relatives.
Reference 1 name and occupation
Address
Phone number
Reference 2 name and occupation
Address
Phone number
Reference 3 name and occupation
Address
Phone number
What are the best times to contact you about your application?
PLEASE READ BEFORE SUBMITTING:

The facts set forth in my application for employment are true and complete.
✔ I understand that if employed, any false statement on this application may result in my dismissal.
✔ I understand that this application is not and is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me.
✔ I understand and agree that my employment is ”AT-WILL” and can be terminated by either party with or without notice, at any time, with or without reason. No one other than the President of NVIC has the authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing and then only in writing signed by the President.
✔ I understand that my employment with the NVIC shall be probationary for a period of ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relation with NVIC is at-will and may be terminated at any time.
✔ I understand that if I am NOT selected for employment this application will remain in an active status for a period of (90) ninety days and then will be stored for record purposes only for a total of 180 days. Unsuccessful candidates with continued interest in employment must contact a member of Human Resources to be considered for employment.

The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, religion, sex or national origin. Federal law also prohibits other types of discrimination such as age, citizenship, disability, veteran status, attainment of benefits, and participation in union activities. The laws of most states and many localities also prohibit some or all of the above types of discrimination as well as some additional types including, but not limited to, discrimination based upon ancestry, marital status, parental status, sexual orientation, or source of income. The Fair Credit Reporting Act imposes restrictions with respect to credit data. This list, however, is not exhaustive of the grounds on which discrimination is prohibited.