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Desert Arc Employment Application

Name
Address
Are you less than 18 years of age? If yes, a work permit may be required
If hired, can you provide proof of identity and legal authorization to work in the U.S.?
Have you ever applied to this organization before?
Have you ever been employed by this organization before?
Are you able to work overtime?
CAN YOU PERFORM THE ESSENTIAL FUNCTIONS OF THE POSITION FOR WHICH YOU ARE APPLYING WITH OR WITHOUT REASONABLE ACCOMODATION?

Employment Interests

Employment Dates

Employment Type

Type of Employment Seeking:
Hours available:

Education | Skills | Awards

(Name and address of school or institution)

Higher Education

(Name and address of school or institution)

Other Education

(Name and address of school or institution)

Languages

English
Spanish

1. References (List people we may contact who are qualified to evaluate work capabilities.)

2. References (List people we may contact who are qualified to evaluate work capabilities.)

3. References (List people we may contact who are qualified to evaluate work capabilities.)

Employment History

Give employee record, listing current to most recent employer first. Show unemployed or self employed periods and indicate dates and comment on each period. Include part-time or summer work.
May We Contact This Employer?

2. Employment History

May We Contact This Employer?

3. Employment History

May We Contact This Employer?
Clear Signature

Acknowledgement

1. I understand that any offer of employment regarding certain job positions may be conditioned on satisfactorily completion of a medical examination and/or drug and alcohol screen. I agree to sign a release of medical information authorization form and to submit to a medical examination and/or drug screen should Desert Arc condition my offer of employment upon successful completion of such an examination or screening. 2. I certify, under penalty of perjury, that all of the above information is true and complete, and I understand that any misrepresentation, falsification or omission of information may result in the denial of employment or, if hired, may result in termination. 3. I authorize Desert Arc to contact my former employers, references and any and all other persons and organizations for information bearing upon my qualifications for employment. I further authorize the listed employers, schools and personal references to give Desert Arc (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have. 4. I EXPRESSLY AGREE AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT HAVING NO SPECIFIC TERM IS BASED UPON MUTUAL CONSENT AND MAY BE TERMINATED AT WILL, WITH OR WITHOUT CAUSE OR NOTICE, BY EITHER PARTY (DESERT ARC or me). 5. Except as required in the performance of my duties, I understand and agree that I will not at any time during or after my employment use, disclose or disseminate any confidential information or any other information of a secret, proprietary, or generally undisclosed nature relating to Desert Arc, or its products, customers, employees, plan or procedures. I agree to deliver to Desert Arc any and all copies of confidential information, or other Company property, upon termination of the employment relationship or at any time upon Desert Arc’s request. I also agree not to solicit clients or employees of the Organization either during my employment or after my employment termination. 6. I acknowledge that I have read all of the above statements and that I understand them. In addition, the statements above supersede and replace any prior understandings or discussions I have had with Desert Arc and set forth the complete agreement between me and Desert Arc regarding these matters.