Last Name

How were you referred to JGVE?

JGVE Website Other Website (specify below) Advertisement (specify below) Employee referral (specify below) Agency (specify below) Other (specify below)

First Name

Name of referral source:

Middle Initial

Social Security Number

Have you ever been employed by or contracted with JGVE? Yes No Full-time Contractor

Home Phone

If so, what position did you hold?

Business Phone

Who was your manager?

E-mail Address

Employment Interest

Permanent Address

Position Desired

City

Salary Desired

State

Date Available

Zip

Have you interviewed for another position at JGVE?
  Yes   No

Previous address if at current address less than 5 years:

If so, when and what position?

Education and Training

Driver’s License Number

Last level completed

High school College or University Graduate School

State

Please list names of high school, technical school, college, and other. INCLUDE: city, state, your major, your degree, and the month & year of your degree.

Citizenship: Are you a United States Citizen?
  Yes    No

If you are not a United States Citizen, are you eligible to work in the U.S. and would you be able to provide the necessary documents of proof of legal right to work upon hire?  Yes  No

Remember to include the city, state, your major,
your degree, and month/year of degree

Have you ever been convicted of a felony? Yes No

If yes, please give date, place, offense, and outcome. Previous convictions to not necessarily disqualify an applicant for employment.

In consideration of employment, I agree to conform to the rules and regulations of JGVE, Inc. I further agree that either I or the Company may terminate my employment with or without cause and with or without prior notice at any time. Finally, I understand that no representative of the Company other than an Executive Officer has the authority to enter into any agreement for employment for any specified period of time, or to otherwise after the foregoing.

Additional education, vocational, professional, military, or other information you feel may be helpful to us in considering your application.

NOTE: UPON SUBMISSION OF THIS FORM, you will automatically be taken to the:
1. Sexual Offender Form and then the
2. Employment History Form.

Dated This Day

I certify that the information given me in this application is true in all respects, and I agree that if the information is given is found to be false in any way, it shall be considered sufficient reason for denial of employment or discharge. I authorize the use of ay information in this application to verify my statements, and, except as indicated above, I authorize the past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous education or employment record. I release all such persons from liability or damages on account of having furnished such information. I consent such investigations as JGVE, Inc. may make regarding my driving records, law enforcement records, credit reports, and my general background. I further understand that all applicable portions of this application (3 pages) must be completed or I will be ineligible for consideration for the position for which I am applying.
IMPORTANT: if you do not understand or if you disagree with any portion of the above certification, do not type in your name before discussing with JGVE, inc. 

Dated This Day

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