Safe Home Arrival

Employment Application

First Name

Last Name

Street Address

City

State

Phone Number

Social Security Number

Driver's License (State/Number)

Who should be contacted if you are involved in an emergency?

Job Position Applied For

Salary Desired

Who referred you to our company?

Have you applied to our company previously?

Are you at least 18 years old?

How will you get to work?

Are you willing to work any shift, including nights and weekends?

If you are offered employment, when would you be available to begin work

If applicable, are you available to work overtime?

If hired, are you able to submit proof that you are legally eligible for employment in the United States?

What is your level in the following skill: Typing (One represents poor ability, while five represents exceptional ability)?

What is your level in the following skill: Microsoft Office Suite Word, Excel, etc. (One represents poor ability, while five represents exceptional ability)?

What is your level in the following skill: Accounting/Bookkeeping (One represents poor ability, while five represents exceptional ability)?

What is your level in the following skill: Answering telephones (One represents poor ability, while five represents exceptional ability)?

What is your level in the following skill: Customer service (One represents poor ability, while five represents exceptional ability)?

Your current or most recent employment

College/University Name and Address

Did you receive a degree?

High School/GED Name and Address

Did you receive a degree?

Other Training (graduate, technical, vocational):

Please indicate any current professional licenses or certifications that you hold:

List any two non-relatives who would be willing to provide a reference for you.

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for the rejection of my application or, if employment commences, immediate termination.

I authorize Safe Home Arrival to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Company President, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Safe Home Arrival, except in a specific written contract of employment signed on behalf of the organization by its Company President, has the power to alter or vary the voluntary nature of the employment relationship.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION, AND I UNDERSTAND AND AGREE TO ITS TERMS.