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  • Personal Information

  • MM slash DD slash YYYY

  • Education


  • Prior Employment

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Military Service

  • Branch of ServiceFromToRank & DutiesDate Discharged

  • References

  • NameTitleAddressPhoneYears Known / Relationship 

  • Additional Information


  • Applicant's Statement

    The above information is true and complete to the best of my knowledge. Should I be employed by The EC3, any misrepresentation or false statement contained herein may be considered cause for possible dismissal. The EC3 has my permission to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment, personal history or credit standing and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice to me. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to The EC3.

    I also understand that certain positions at The EC3 may require completion of a drug screen prior to employment, that employment is contingent on a satisfactory drug screen result, and that I may be required to complete a medical exam after employment. The EC3 maintains a smoke-free environment and prohibits smoking in company buildings, shops and field offices.

    I understand that this application does not constitute an employment contract of any kind. Should I be employed by The EC3, I may resign such employment at any time at my discretion with or without prior notice, and The EC3 may terminate my employment at any time at their discretion, with or without cause and with or without prior notice.

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