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Business Opportunity/Employment Application

Qualified applicants receive equal consideration. No question is asked for the purpose of excluding any applicant due to race, creed, color, national origin, religion, age, sex, handicap, veteran status, marital status, sexual orientation, or any other characteristic protected by law. We offer opportunities for purchasing our License to Publish using the Chronicles Platform and employment opportunities equally to all. For info about our License to Publish go to http://bit.ly/pubyourown

First & Last Name

Address

City

State/Province/Region

Postal Code

E-Mail

Years You Lived Here

Day Phone

Night Phone

Desired Position.

How did you hear of this opportunity?

EMPLOYMENT/WORK HISTORY

Are you employed?

Yes
No

If “Yes”, may we contact your present employer?

Yes
No

Please list your most recent employer and your first full-time employer.

Most Recent Employer

Address

City

State/Province/Region

From

Supervisor's Name

Salary

Type of Work

Reason for leaving

First Full Time Job

Address

City

State/Province/Region

From

Supervisor's Name

Salary

Type of Work

Reason for leaving

EDUCATION

Graduated High School?

Yes
No

College/University

Major Course of Study

Name of Institution Granting Your Degree

City/State

PERSONAL INFORMATION

Are you at least 18?

Yes
No

Are you legally authorized to work in the U.S.? (If hired you will be required to provide proof of work authorization).

Yes
No

Have you ever been convicted of a felony?

Yes
No

If “Yes”, give details (convictions are not automatic bar to employment).

Criminal Background

Are you skilled at operating any of the following computer software?

List Other Skills Here

REFERENCE

Who would hire you or partner with you if they were looking for someone with your skills?

First & Last Name

Occupation

Address

City/State/Zip

Day Phone

Relationship

How long have you known this reference?

Date You Can begin Publishing or Working.

We subscribe to the guidelines of the Drug-Free Workplace Network. For employment at company premises, Pre-Employment Drug Testing is a Requirement

PLEASE READ CAREFULLY BEFORE SUBMITTING YOUR APPLICATION.

All information provided is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in rejection or subsequent dismissal. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my work ethics for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information whether favorable or unfavorable, about me or my work history.

I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me. I understand that upon receiving a job offer or a License to Publish, a physical examination and drug screening may be required. (Note: If this is a job requirement, you will be notified.)

Regardless of whether or not I become employed by the company or am granted a License to Publish using the Chronicles Platform, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the company or the granting of a License to Publish is on an at-will basis and that same may be terminated with or without cause, and without notice, at any time, at my option or the company’s unless specifically provided otherwise in a written employment contract or a License to Publish Agreement.

I further understand that no company employee or representative has the authority to enter into a contract of any nature or terms and conditions other than an officer or official of the company, and then only by means of a signed written document.

I understand the company has a policy of no smoking on the premises.

Do you certify that you have read and accept the above statement?

Yes

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