IAG Performance Employment Application


Please complete the form below so that we may better serve you. Formal resumes should be sent (HERE)



Personal Information:


First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone:


Employment Desired:


Date You Can Start:
Salary Desired:
Are you employed now?
If employed, may we contact your present employer?
Are you legally authorized to work in the US?
Have you ever applied to this company before?
When did you apply in the past?:


Education History:


High School Education?
Name of the High School?:
Location of the High School?:
High School years attended?:
Subjects Studied?:
Did you graduate High School?


College Education?
Name of the College?:
Location of the College?:
College years attended?:
Subjects Studied?:
Did you graduate College?


Trade, Business or Correspondence School?
Name of the Trade or Business School?:
Location of the Trade or Business School?:
Trade school years attended?:
Subjects Studied?:
Did you graduate Trade School?


General Information:


Subjects of special study or research?:
Special Training?:
Special Skills?:
U.S Military or Naval Service?:
Military Rank?:


Former Employers:


List the last three employers starting with the current or most recent first.

Name of most recent / current employer?:
Address of most recent / current employer?:
Start date and finish / current date:
Salary received at the most recent / current employer?:
Position held at the most recent / current employer?:
Reason for leaving your most recent / current employer?:


Name of second most recent employer?:
Address of most second most recent employer?:
Start date and finish date:
Salary received at the second most recent employer?:
Position held at the second most recent employer?:
Reason for leaving your second most recent employer?:


Name of third most recent employer?:
Address of most third most recent employer?:
Start date and finish date:
Salary received at the third most recent employer?:
Position held at the third most recent employer?:
Reason for leaving your third most recent employer?:


References:


Give below the names of three persons not related to you, whom you have known at least one year.

List the last three employers starting with the current or most recent first.
First and Last Name of your first reference?:
Address of your first reference?:
Business of your first reference?:
Years known of your first reference?:

First and Last Name of your second reference?:
Address of your second reference?:
Business of your second reference?:
Years known of your second reference?:

First and Last Name of your third reference?:
Address of your third reference?:
Business of your third reference?:
Years known of your third reference?:


Authorization:


"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."





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