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While completing this form please do not hit enter to get to the next form field, doing so will automatically submit your application, rather use the tab key. Once completed hit the submit button to send you application.

Personal Data
*Last Name: 
 *First Name: 
 Middle Initial:

*Address: 
*City: 
 *State: 
 *Zipcode: 
*Home Phone: 
 Cell Phone:
  

*Are you legally permitted to work in the United States?:  

Position Data
*Position Applying For:

Other:  
*Date Available: 
 *Salary Requirements: 
  

General Data
*Have you ever been convicted of a felony?  
This may not necessarily disqualify you from potential employment with PNY.


If yes, please explain:
*Have you previously applied for another position at PNY?  
If yes, what position and please indicate date:
Are you willing to travel, if the position you are applying for requires it?
If yes, how often?
*Are you proficient with the English language?  

Education Data
Type School Name City & State Degree
Received		 Field of
Study
Graduate School
College
High School
Trade and/or
Professional School

Training and Skills Data
Please list any special training and skills:


List Professional Licenses, Certificates, or Patents:


List any other languages that you can fluently speak:

Employment History (Please start with most recent employment first)
Position 1
Company Name:    
Company Address:
Dates Employed - From: to
Brief Job Responsibilities:


Starting Position:      Starting Salary: 
Final Position:           Final Salary:      
Supervisor Name:     Phone #:            
Reason for Leaving: 
May we contact?
Position 2
Company Name:    
Company Address:
Dates Employed - From: to
Brief Job Responsibilities:


Starting Position:      Starting Salary: 
Final Position:           Final Salary:      
Supervisor Name:     Phone #:            
Reason for Leaving: 
May we contact?
Position 3
Company Name:    
Company Address:
Dates Employed - From: to
Brief Job Responsibilities:


Starting Position:      Starting Salary: 
Final Position:           Final Salary:      
Supervisor Name:     Phone #:            
Reason for Leaving: 
May we contact?
Position 4
Company Name:    
Company Address:
Dates Employed - From: to
Brief Job Responsibilities:


Starting Position:      Starting Salary: 
Final Position:           Final Salary:      
Supervisor Name:     Phone #:            
Reason for Leaving: 
May we contact?

Application Statement


I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct.

I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to cancel further consideration of this application, or immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, it's representatives, employees, or agents to contact and obtain information from all references, employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I herby waive any and all rights and claims I may have regarding the employer, its agents, employees, or representatives for seeking, gathering, and using such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute any agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard.

I certify that I have read, fully understand and accept the terms of the foregoing Application Statement.


* Do not complete this section now*
Signature of Applicant:





Date:







 

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