Personal Information
Address
E-Mail Address
Record of Education
Professional & Community Involvement
Employment History In applying for employment, it is understood that we reserve the privilege of contacting past employers regarding references.
If so, describe any special skills or abilities you developed which relate to the job you are seeking.
The following information concerning citizenship is furnished for the purpose of securing employment with NEONA, and is furnished with full knowledge of Section 911 of Title 18 of the U.S. Code, which provides as follows: “Whosoever falsely and willfully represent himself/herself to be a citizen of the United States shall be fined not more than $1,000.00 or imprisoned not more than 3 years, or both.”
Note: If hired, you will be required to furnish proof of U.S. Citizenship or your authorization to work in the U.S. as specified under applicable U.S. Immigration Laws. If employed, you must show documents that prove your identity and employment eligibility as required by the Immigration Reform and Control Act of 1986.
NOTE: This section is not applicable to New Jersey residents.
If yes, give date, court, nature of offense, and disposition.
Nature of Offense
Disposition
References Please provide professional references - current and past supervisors/managers.
In the box below, please briefly indicate other information about your professional or academic background and career goals which may be pertinent to an employment decision.
Resume
To Be Read and Signed By Applicant
THIS CERTIFIES THAT THIS APPLICATION WAS COMPLETED BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND AND AGREE THAT ANY MISREPRESENTATION OR OMISSION OF FACTS IN MY APPLICATION MAY BE JUSTIFICATION FOR REFUSAL TO HIRE, OR TERMINATION OF EMPLOYMENT.
Initial
I WARRANT THAT I AM NOT CURRENTLY A PARTY TO ANY EMPLOYMENT OR NON-COMPETE AGREEMENT WHICH MAY LIMIT MY ABILITY TO ACCEPT OR PERFORM THE POSITION FOR WHICH I AM APPLYING.
Initial
I FURTHER UNDERSTAND THAT AN INVESTIGATIVE REPORT MAY BE MADE AS TO MY CHARACTER AND GENERAL REPUTATION. I AUTHORIZE ALL PAST EMPLOYERS, SCHOOLS, PERSONS AND ORGANIZATIONS HAVING RELEVANT INFORMATION OR KNOWLEDGE TO PROVIDE IT TO NEONA OR ITS DULY AUTHORIZED REPRESENTATIVE, FOR ITS USE IN DECIDING WHETHER OR NOT TO OFFER ME EMPLOYMENT AND SPECIFICALLY WAIVE ANY REQUIRED WRITTEN NOTIFICATION. I HEREBY RELEASE EMPLOYERS, SCHOOLS, PERSONS AND ORGANIZATIONS FROM ALL LIABILITY IN RESPONDING TO INQUIRIES IN CONNECTION WITH MY APPLICATION.
Initial
I AGREE THAT IF I AM EMPLOYED BY NEONA, THE EMPLOYMENT WILL BE EMPLOYMENT AT WILL, AND EITHER I OR NEONA MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME FOR ANY REASON WITHOUT NOTICE, AND THIS APPLICATION SHALL BE A PART OF MY TERMS OF EMPLOYMENT.
Initial
IN SIGNING THIS FORM, I CERTIFY THAT I UNDERSTAND ALL OF THE QUESTIONS AND STATEMENTS IN THE APPLICATION.
NOTICE OF NONDISCRIMINATION - As an EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER, NEONA does not discriminate on the basis of race, color, religion, national origin, ancestry, sex, age, disability, sexual orientation, genetic disposition, or status as disabled veteran or veteran of the Vietnam Era.
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