NetSystems, LLC Employment Application
Please fill out the application as completely as possible.  You will be given the opportunity to attach your resume and cover letter, but a resume
is not considered an appropriate substitute for filling out the application completely.
 *required field
 PERSONAL INFORMATION

*First name:

Middle initial:

*Last name:

Maiden name:

*Address:

*City:

*State:

*Zip code:

Phone number:

*Best method to contact you
(please list appropriate
times and telephone numbers):

Social Security Number:
(optional)

E-mail:

Position applied for:

How did you hear about us?

May we contact you at work?

 YesNo

Have you submitted an
application here before?

 YesNo

If yes, give date(s) and position(s):

Date available for work:

Are you legally eligible for
employment in this country?

 YesNo

*Expected salary (this should be a number):

   YearlyHourly

Are you able to meet the attendance
requirements of the position?

 YesNo

Will you relocate if the job requires it?

 YesNo

Have you ever been bonded?

 YesNo

Will you work overtime if required?

 YesNo

If no, please explain:

Do you have a driver's license?

 YesNo

 Driver's license number:

Expiration date:

State of issue:

Driver's license type:

 RegularCommercial (CDL)

Have you had any accidents
during the past three years?

 YesNo

How many?

Have you had any moving violations
in the past three years?

 YesNo

How many?

Have you ever pled "guilty" or
" no contest" to, or been
convicted of a crime?

 YesNo

If yes, please provide
date(s) and details:
Answering yes to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation,
rehabilitation, and position applied for will be taken into account.  
 

EMPLOYMENT HISTORY

Please list your last four employers, beginning with your most recent job held.    

 May we contact your current employer?

 Yes No  

Employer:
Your Job Title:

 Address, City and State:

Employment dates:

          From                               To
 

 Immediate supervisor and title:

 Salary or Wages:

         Starting                          Ending
 

 Telephone:

 Job Duties (list all duties related to this position):

 Reason(s) For Leaving:

 Employer:

Your Job Title:

 Address, City and State:

Employment dates:

            From                               To
 

 Immediate supervisor and title:

  

 Salary or Wages:

           Starting                          Ending

 Telephone:

 Job Duties (list all duties related to this position):

Reason(s) For Leaving:

Employer:

Your Job Title:

Address, City and State:

Employment dates:

           From                               To
 

 Immediate supervisor and title:

 Salary or Wages:

          Starting                          Ending
 

 Telephone:

    

 Job Duties (list all duties related to this position):

Reason(s) For Leaving:

Employer:

Your Job Title:

Address, City and State:

Employment dates:

          From                               To
 

 Immediate supervisor and title:

 Salary or Wages:

          Starting                          Ending
 

 Telephone:

    

 Job Duties (list all duties related to this position):

Reason(s) For Leaving:
 
EDUCATIONAL BACKGROUND

School

Years
completed
Did you graduate?

Degree diploma

GPA or
class rank

Major
Minor

  Yes No 

  Yes No 

  Yes No 

INDUSTRY CERTIFICATIONS
(Please note any certification efforts in progress, along with your status and plans for completion.)
 
REFERENCES
List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.

 Name

Telephone number

Relationship

Number of years known 

ADDITIONAL INFORMATION (Optional)
List professional, trade, business or civic associations and any offices held (exclude memberships that would reveal race, color, religion, sex,
national origin, citizenship, age, mental or physical disabilities, veteran/reserve/national guard, or any other similarly protected status):
List special accomplishments, publications, awards, etc. (exclude items that would reveal race, color, religions, sex, national origin, citizenship,
age, mental or physical disabilities, veteran/reserve/national guard, or any other similarly protected status):
List any additional information you would like us to consider:
Paste your cover letter and resume in the fields below:

(To retain Word formatting, use the "Paste from Word" button .)
INTRODUCTORY MESSAGE
Use this area for a cover letter type of introduction:
RESUME

APPLICATION FORM TERMS

PLEASE READ CAREFULLY

In exchange for the consideration of my job application by NetSystems, LLC (hereinafter called “the Company”), I agree that:

In the event of entry into any type of employment relationship, either in position applied for or any other position, either the

undersigned or NetSystems, LLC may end the employment relationship at any time, without specified notice or reason

(employment-at-will.)  If employed, I understand that the Company may unilaterally change or revise their benefits,

policies, and procedures.  I authorize investigation of all statements contained in this application.  I understand that the

misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.  I hereby

give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others,

and hereby release the Company from any liability as a result of such contact.

 

I also understand that (1) the Company has a drug and alcohol policy that provides for preemployment testing as well as testing

after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued

employment is based on the successful passing of testing under such policy.  I further understand that continued employment

may be based on the successful passing of job-related physical examinations.

 

I understand that, in connection with the routine processing of this employment application, the Company may request from

a consumer reporting agency an investigative consumer report including information as to my credit records, character,

general reputation, personal characteristics, and mode of living.  Upon written request from me, the Company will provide

me with additional information concerning the nature and scope of any such report requested by it, as required by the

Fair Credit Reporting Act.

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By clicking on the submit button below, you certify that you have read the application form terms, and agree to its content. You further
certify that the information submitted in this application is true and correct to the best of your knowledge.

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This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.