Employment Application

Applicant Information
Last:   First:   M.I.:  Date:
 
Street Address: Apt/Unit #:
 
City:        State:        Zip:    
 
Home Phone: Cell Phone: 
 
Work Phone: E-mail Address:  
 
Date Available:   Soc. Security No.: Desired Salary:
 
Position applied for: Location?
 
How did you learn of this opportunity?If other, please specify:
 
If Employee Referral, please specify employee name:
 
Are you authorized to work immediately for any employer in the U.S.? Yes    No
 
Have you ever for NEW? Yes    NoIf yes, when?
 
Have you ever been convicted of a felony or misdemeanor
(other than traffic violations)?
 Yes    No   A conviction will not necessarily bar you from employment.
 
If yes, explain:

EDUCATION
 
High Level of Education Completed:    GED   High School    College    Other
 
High School: Address:
From: To: Did you graduate? Yes    No    Degree:
 
College: Address:
From: To: Did you graduate? Yes    No    Degree:
 
Other: Address:
From: To: Did you graduate? Yes    No    Degree:

MILITARY SERVICE
Branch: From: To:
Rank at Discharge: Type of Discharge:
If other than honorable, explain:

MISCELLANEOUS
What professional, job-related licenses or certifications do you hold?
With what computer hardware, software or operating system do you have experience with?


Previous Employment (most recent position held first)
Company 1:                    Employer Phone: 
Employer Address:     Supervisor: 
Your Position:     Starting Salary (hourly):  Starting:    Ending: 
Employed from:  (MM/YY)   to:  (MM/YY)       Full-time   Part-time
Responsibilities:
Reason for leaving: 
May we contact your previous supervisor for a reference? Yes    No

Company 2:                    Employer Phone: 
Employer Address:     Supervisor: 
Your Position:     Starting Salary (hourly):  Starting:    Ending: 
Employed from:  (MM/YY)   to:  (MM/YY)       Full-time   Part-time
Responsibilities:
Reason for leaving: 
May we contact your previous supervisor for a reference? Yes    No

Company 3:                    Employer Phone: 
Employer Address:     Supervisor: 
Your Position:     Starting Salary (hourly):  Starting:    Ending: 
Employed from:  (MM/YY)   to:  (MM/YY)       Full-time   Part-time
Responsibilities:
Reason for leaving: 
May we contact your previous supervisor for a reference? Yes    No

Company 4:                    Employer Phone: 
Employer Address:     Supervisor: 
Your Position:     Starting Salary (hourly):  Starting:    Ending: 
Employed from:  (MM/YY)   to:  (MM/YY)       Full-time   Part-time
Responsibilities:
Reason for leaving: 
May we contact your previous supervisor for a reference? Yes    No

Company 5:                    Employer Phone: 
Employer Address:     Supervisor: 
Your Position:     Starting Salary (hourly):  Starting:    Ending: 
Employed from:  (MM/YY)   to:  (MM/YY)       Full-time   Part-time
Responsibilities:
Reason for leaving: 
May we contact your previous supervisor for a reference? Yes    No

REFERENCES
Please list three professional references that are familiar with the quality of your work, and have worked directly with you.
(At least one previous manager/supervisor/business owner required.)
 
Full Name: Relationship:
Company: Phone:
Address:
 
Full Name: Relationship:
Company: Phone:
Address:
 
Full Name: Relationship:
Company: Phone:
Address:
 

Disclaimer and Signature
N.E.W. Customer Service Companies, Inc. (N.E.W.) is committed to Equal Employment Opportunity in all aspects of its operations. Employment, compensation and progression are based on qualifications and job related factors without regard to race, color, age, sex, religion, national origin, veteran status, disability or marital status or any other status protected by applicable law.

NEW handles sensitive financial information on behalf of its customers. Therefore, NEW may have background investigations conducted or obtain credit reports concerning prospective employees. By completing this application for employment, you are consenting to the performances of these investigations.

Please complete all sections. Failure to do so could delay processing of your application. We will review your qualifications and will make every effort to contact you as quickly as possible.

Entering your name below and returning this draft in full, constitutes an electronic signature of this Agreement, which is enforceable by law; you are agreeing to authorize NEW to thoroughly investigate your references, work records, education and other matters related to your suitability for employment and, further, authorize your current and former employers to disclose to the NEW Customer Service Company, Inc. any and all letters, reports and other information pertaining to your employment with them, without giving you prior notice of such disclosure. In addition you hereby release NEW, your current and former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
Signature:     Date:


I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.