Applicant Information

Emergency Contact

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

Position Information

Full or Part Time? Full TimePart Time

Are you at least 18 years old? YesNo

How will you get to work?

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

If no, please state any limitations

If applicable, are you available to work overtime? YesNo

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

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

Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation? YesNo

What reasonable accommodation, if any, would you request?

Applicant's Skills

List any skills that may be useful for the job you are seeking and the years of experience you have with them.

Applicant Employment History

List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment.

May we contact your present employer? YesNoN/A

Applicant's Education and Training

Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.

Military Service: YesNo

References

CERTIFICATION Acknowledgement and authorization

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 rejection of my application, or if employment commences, immediate termination.

I authorize CARPE DIEM PROTECTION LLC 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 Principal, 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 CARPE DIEM PROTECTION LLC, except in a specific written contract of employment signed on behalf of the organization by its Principal, 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.