• Image-86
  • HomeBlis Application for Employment

  • Electronic Signature

    By typing your first and last name below and submitting this employment application form electronically, you acknowledge having read and understood our employment practices and policies as stated above.

  • APPLICATION FOR EMPLOYMENT

  • HomeBlis Is an Equal Opportunity Employer

     

  •  - -
  •  (If you are hired, you may be required to submit proof of age.)

  •  -
  • WORK HISTORY / EXPERIENCE

    List names of employers in consecutive order with present or last employer first. Account for all periods of time including military service as well as any periods of unemployment. If self-employed, give firm name and supply business references.
  •  -
  •  - -
  •  - -
  •  -
  •  - -
  •  - -
  •  -
  •  - -
  •  - -
  • Special Skills

  • Education

    List Name and Address of Schools
  • 2nd Reference

  • References

  • Give three references, not relatives or former employers

  • AFFIDAVIT, CONSENT AND RELEASE 

    PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING 

  • I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. 

    I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

    I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post employment drug screen as a condition of employment, if required.

    I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

    I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.

    I have read, understand, and by my signature (typing my name below) consent to these statements.

  •  - -
  • Upload a File
    Cancelof
  • Should be Empty: