Career Application Form 1Personal Information2Education & Skills3Employment History4Emergency Information5Certification & Authorization PERSONAL INFORMATIONName* First Middle Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone*Email* Position(s) Applying for*Date Available to Begin Work* MM slash DD slash YYYY Are you at least 18 years old (If not, you may be required to provide authorization to work)*NoYesAre you prevented from lawfully becoming employed in this country because of visa or immigration status?*NoYesHow did you hear about ACLAMO? Internet School/Employer Friend/Relative Other, please specify: Please tell us how your first heard about usHave you been convicted of a felony in the last 7 years? (Conviction will not disqualify an applicant from consideration for employment.)*NoYesPlease provide some details of the felony conviction:Have you applied for employment with ACLAMO before?*NoYesPlease select date of previous application MM slash DD slash YYYY Have you ever been employed by ACLAMO?*NoYesPlease select date of previous employment MM slash DD slash YYYY Reason for leaving: EDUCATIONPlease list all relevant education. (i.e. GED, high school, college) For each please provide, Name of School Address Course of Study Degree or Certification Education 1*Education 2Education 3Education 4Education 5SKILLSList any related courses, seminars, certifications:Computer skills (i.e. Microsoft Office, programming, etc.):FOREIGN LANGUAGE SKILLSPlease list all the languages known.Language 1Language 1 Reading LevelRate from 1-5, with 5 meaning fluent12345Language 1 Writing LevelRate from 1-5, with 5 meaning fluent12345Language 1 Speaking LevelRate from 1-5, with 5 meaning fluent12345Language 2Language 2 Reading LevelRate from 1-5, with 5 meaning fluent12345Language 2 Writing LevelRate from 1-5, with 5 meaning fluent12345Language 2 Speaking LevelRate from 1-5, with 5 meaning fluent12345Language 3Language 3 Reading LevelRate from 1-5, with 5 meaning fluent12345Language 3 Writing LevelRate from 1-5, with 5 meaning fluent12345Language 3 Speaking LevelRate from 1-5, with 5 meaning fluent12345 Start with your present or most recent position. Include job-related military service or volunteer activities. Please fill out completely, even if attaching a resume. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status. Employer 1EmployerEmployer AddressEmployer Phone NumberYour Job Title/DepartmentYour Duties and ResponsibilitiesName of ManagerEmployment Start Date MM slash DD slash YYYY Employment End Date MM slash DD slash YYYY Starting SalaryEnding SalaryReason for LeavingEmployer 2EmployerEmployer AddressEmployer Phone NumberYour Job Title/DepartmentYour Duties and ResponsibilitiesName of ManagerEmployment Start Date MM slash DD slash YYYY Employment End Date MM slash DD slash YYYY Starting SalaryEnding SalaryReason for LeavingEmployer 3EmployerEmployer AddressEmployer Phone NumberYour Job Title/DepartmentYour Duties and ResponsibilitiesName of ManagerEmployment Start Date MM slash DD slash YYYY Employment End Date MM slash DD slash YYYY Starting SalaryEnding SalaryReason for LeavingCurrent EmploymentAre your currently employed?*YesNoMay we contact your current employer?YesNo Emergency InformationPlease provide an emergency contactName*Phone Number*Relationship to Applicant*Professional ReferencesPlease provide 2 professional references:Reference 1 Name*Reference 1 Phone Number*Reference 1 Relationship to Applicant*Reference 2 Name*Reference 2 Phone Number*Reference 2 Relationship to Applicant*Personal ReferencePlease provide 1 personal reference:Name*Phone Number*Relationship to Applicant* I certify that the answers given here in are true and complete to the best of my knowledge. I understand that false or misleading information given in my application or interview will cause for denial of employment or subsequent termination of employment, regardless of when discovered. I authorize ACLAMO to inquire into my educational, professional, and past employment history as needed to research my qualifications for employment. I hereby give my consent to any current and former employer and educational institution to provide employment-related information about me to ACLAMO and release from liability ACLAMO and those parties furnishing such information with respect to the information supplied. If hired, I understand that my employment is ‘at will.’ That is, ACLAMO and I both have the right to terminate my employment at any time, for any reason with or without consent. I further understand that no representation, whether oral or written by any representative of ACLAMO, at any time, may constitute a contract of employment. Before being hired, I understand that I will be required to complete all-state mandated clearances and provide original documents specified by the federal government establishing my identity and eligibility for employment in the United States. If hired, I agree to abide by all of ACLAMO’s policies. I understand that any benefit, policy, or practice may be modified or eliminated at any time without notice. I hereby acknowledge that I have read and agree to the above statements and grant permission to confirm the information supplied on this application by me. Type Full Legal Name:*Please Upload Your Resume (PDF, DOCX)Accepted file types: pdf, docx, Max. file size: 10 MB.Please Upload Your Cover Letter (PDF, DOCX)Accepted file types: pdf, docx, Max. file size: 10 MB. Δ
