Employment Application
An equal opportunity and affirmative action employer
     

 

Personal Information
Your Name - Last (*Required) First (*Required) M  
 
Other names by which you have been known (for verification and reference checking purposes)
Primary Phone (*Required) Secondary Phone Email Address (*Required)
Permanent Address City State Zip (* Complete Address Required)
Previous Address (if at current address less than 5 years) Driver's License Number / State
Instructions (Check Yes if the statement is true)

I certify that I am a) a US Citizen or  b) a non-US Citizen that is eligible to work in the United States and I can provide the necessary documents as proof of my legal right to work upon hire. *Required - If you cannot certify that either statement is true we are unable to consider your application at this time due to United States immigration rules and regulations.*

Are you under 18?  If yes and still in high school, you may be required to provide a work permit upon hire. *Required
Have you ever been convicted of a felony? (Previous convictions do not necessarily disqualify you from employment)
If YES, give date, place, offense, and outcome
Have you ever been employed by Bolla Management?  If YES, give what position (s) you held and the dates of your employment.

How were you referred to Bolla Management?  
                                                           Specify 
                                                                                                                         (other website, employee name, other, etc.)

Employment Interest
Position Desired Salary Desired Date Available
Have you interviewed for another position at   If YES, when?

Education and Training
Indicate last level completed: High School College or University Graduate School
Name of High School, Technical School, and College City, State Major Degree Month/Year of Degree

Additional education, vocational, professional, military, or other information you feel may be helpful to us in considering your application

Employment History - List the most recent Employer first.
Company Name Street Address
City State Zip  
May we contact this employer?           Yes No
Starting Job Title Final Job Title
Supervisors Name & Title Phone
Reason for Leaving
Employment Dates Rate of Pay
From: - To: Start: - End:
Job Duties      
 
Company Name Street Address
City State Zip  
May we contact this employer?  Yes No
Starting Job Title Final Job Title
Supervisors Name & Title Phone
Reason for Leaving
Employment Dates Rate of Pay
From: - To: Start: - End:
Job Duties      
 
Company Name Street Address
City State Zip  
May we contact this employer?  Yes No
Starting Job Title Final Job Title
Supervisors Name & Title Phone
Reason for Leaving
Employment Dates Rate of Pay
From: - To: Start: - End:
Job Duties      

Business Reference Data - Please list at least one present or former managers
Name Email Address Phone Business Relationship

Read Carefully and Sign

I certify that the information contained in this application is correct to the best of my knowledge, and I understand that any mis-statement or omission of information is grounds for ending the hiring process or dismissal.  I authorize verification of information provided on this application; and authorize the references listed above to give you all pertinent information concerning my previous employment; and release all parties from all liability for any damage that may result from furnishing same to Bolla.  I also hereby authorize Bolla Management Corp. or its agent to conduct a criminal and/or financial background check.  I understand that I may be subject to pre-employment drug testing and drug testing at any time during my employment at the discretion of Bolla Management Corp.  In consideration of my employment, I agree to conform to the rules and regulations of Bolla Management Corp.  I further agree that either I or the Company may terminate my employment with or without cause and with or without prior notice, at any time.  Finally, I understand that no representative of the Company other than an Executive Officer has the authority to enter into any agreement for employment for any specified period or time, or to otherwise alter the foregoing.

* This application is not an offer of employment.  Completing and submitting this application signifies an inquiry on your part for possible employment with Bolla Management and in no way guarantees that you will be hired. 
 

Signature:

 Date

 
Enter your full name above