Application

Applicant Information
Today's Date
Name
Address
Phone
Email
Please list emergency contact name, phone, and relationship
Are you at least 18 years of age?
Are you legally authorized to work in the United States?
Position Desired
Interested in
Minimum Salary Desired
Date available for work
If previously employed by NPI, indicate dates and title
Work Experience - List most recent first.
#1 Please list: Employer, Supervisors Name/Title, Address, Phone, Dates Employed, Most recent position, responsibilities, starting salary, ending salary and reason for leaving.
#2 Please list: Employer, Supervisors Name/Title, Address, Phone, Dates Employed, Most recent position, responsibilities, starting salary, ending salary and reason for leaving.
#3 Please list: Employer, Supervisors Name/Title, Address, Phone, Dates Employed, Most recent position, responsibilities, starting salary, ending salary and reason for leaving.
Referral Source
Please list how you heard about NPI? (walk in, newspaper ad, website, employee referral, other)
Please list the name/location, years completed, date graduated and course/major for high school, college, graduate school, tech/business or other
Computer/Software skills
Other skills
REFERENCES - List three persons not related to you, business references preferred
Reference #1 (name, company, phone, email, years acquainted)
Reference #2 (name, company, phone, email, years acquainted)
Reference #3 (name, company, phone, email, years acquainted)
Additional Questions
Have you ever been terminated from employment or asked to resign by an employer
Are you able to perform the essential functions of the job for which you are applying with or without reasonable accommodation
Have you ever been convicted of a felony? If yes, state details. Convictions will not necessarily disqualify applicant; each case is considered individually
Why are you interested in working for NPI?
What strengths would you bring to NPI
What didn't you like about your previous jobs?
I understand that, if hired, my employment is at-will and can be terminated at any time, with or without notice for any reason or no reason. I also understand that while personnel policies, programs and procedures may, of necessity, change from time to time, I will have no contract for any specific term or under and specific conditions, and will have no vested right in any such policies, programs, or procedures and such at-will status is not subject to change absent a written agreement signed by me and by the company’s President or Chief Executive Officer. I understand that consideration for employment in this position is contingent upon the results of a reference and background check. I therefore authorize Name- plates, Inc. to investigate all statements made on my application for employment and to discuss the results of its investigations with those responsible for hiring. I further authorize Nameplates, Inc. to contact my former employer(s) and any listed references or other persons who can verify information and give my consent for former employer(s) and other contracted persons to respond to questions pertaining to information on this application. Further, I release from liability such former employer(s) or other persons contacted by and providing information to Nameplates, Inc. I acknowledge that the information I have supplied is correct to the best of my knowledge and understand that any deliberate falsification, misrepresentations, or omissions of fact may be grounds for dismissal from subsequent employment. I understand that if a conditional offer of employment is made, that it is subject to Nameplates, Inc. policy of satisfactory passing of an employment physical exam and alcohol/drug test. This application is current for ninety (90) days. At the end of this time, if I have not heard from Nameplates, Inc. and still want to be considered for employment, it will be necessary to complete a new application. Nameplates, Inc. is an Equal Opportunity Employer. Nameplates, Inc. does not discriminate in employment and questions on this application are not intended to limit or excuse any applicant’s consideration for employment on a basis prohibited by local, state, or federal law.