SIS NW Job Application

SIS NW Employment Application

1PERSONAL INFORMATION

2APPLICANT QUESTIONS

3EDUCATION AND SKILLS

4EMPLOYMENT HISTORY

5BACKGROUND SPECIFICS

6REFERENCES

7ACKNOWLEDGEMENTS

Name*
First Middle Last
Social Security #*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Alternate Phone
Email

Please include your email address to receive a copy of this application, upon completion.
Position Applied For*

Employment History 1 (of 4)
Please list up to 4 previous employers in chronological order with the present or last employer first. Account for all periods of time including military service and any period of unemployment. If self-employed, give name of company and supply business references.
Company Name*
From:*
Month
Day
Year
To:*
Month
Day
Year
Job Title*
Starting Pay*
Ending Pay*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Reason for Leaving*
Supervisor*
First Last
Phone*
Job Duties and Responsibilities:*
Would you like to proceed with your 2 (of 4) Employment History?*
- Yes
- N/A
Company Name*
From:*
Month
Day
Year
To:*
Month
Day
Year
Job Title*
Starting Pay*
Ending Pay*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Reason for Leaving*
Supervisor*
First Last
Phone*
Job Duties and Responsibilities:*
Would you like to proceed with your 3 (of 4) Employment History?*
- Yes
- N/A
Company Name*
From:*
Month
Day
Year
To:*
Month
Day
Year
Job Title*
Starting Pay*
Ending Pay*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Reason for Leaving*
Supervisor*
First Last
Phone*
Job Duties and Responsibilities:*
Would you like to proceed with your 4 (of 4) Employment History?*
- Yes
- N/A
Company Name*
From:*
Month
Day
Year
To:*
Month
Day
Year
Job Title*
Starting Pay*
Ending Pay*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Reason for Leaving*
Supervisor*
First Last
Phone*
Job Duties and Responsibilities:*

Spectrum Information Services NW, Inc. will not consider for employment any person who does not provide the name and current contact information of at least three PROFESSIONAL references who can and will discuss the applicant’s work history and suitability for the position sought.
Professional Reference 1
Name*
First Last
Business Name*
Phone*
Email
Address
Street Address City State / Province / Region
Professional Reference 2
Name*
First Last
Business Name*
Phone*
Email
Address
Street Address City State / Province / Region
Professional Reference 3
Name*
First Last
Business Name*
Phone*
Email
Address
Street Address City State / Province / Region
AUTHORIZATION & RELEASE FOR REFERENCES
I understand that providing acceptable references is my responsibility and that SIS NW, Inc. may refuse to employ me if I do not provide current contact information for a suitable number of professional references who are both qualified to and willing to discuss with SIS NW, Inc. my experience and my qualifications for the position I am seeking.

I authorize each of the professional references provided by me, as well as any custodian of records at any former employer to release any information regarding my employment, experience and qualifications for the position being sought with SIS NW, Inc. I hereby fully waive any rights or claims I have or may have against the aforementioned, and release them from any and all liability, claims or damages that may directly or indirectly result from the disclosure or release of such information, whether or not that information is favorable or unfavorable to me.
Name*
First Last
Signature*
Date*
Month
Day
Year

I hereby certify that everything on this application and its accompanying documents (Disclosure to Employment Applicant Regarding Procurement of A Consumer Report, and Release Authorization Form), is true and complete and that I have omitted no material facts or information. I understand that regardless of when discovered, any misrepresentation, falsification or material omission of information on this Employment Application and its accompanying documents or in the interview process, will result in no offer of employment being extended to me, or an extended offer being rescinded or in the termination of my employment with Spectrum, depending upon when the misrepresentation, falsification or material omission is discovered.

I understand that once employed by SIS NW, Inc. I will be required to immediately offer satisfactory documentary proof of my right to reside and work in the United States.

I understand that my employment with SIS NW, Inc. will at all times be an “at will” relationship which can be ended by me or by Spectrum, and any time, for any reason or for no reason, with or without notice.

I understand that only the President & Chief Executive Officer of SIS NW, Inc. can modify the “at will” nature of my employment relationship with SIS NW, Inc. and that such modification must be in writing and signed by the President & Chief Executive Officer of SIS NW, Inc. to have any force or effect.

I understand that I will be considered for employment with SIS NW, Inc. only if this application and the required accompanying documents are filled out in their entirety. I also understand that this application will be active for a maximum of thirty (30) days. If I wish to be considered for employment after that time, I must reapply.
Signature*
Date*
Month
Day
Year

SIS NW Employment Application

Employment History 1 (of 4)

Professional Reference 1

Professional Reference 2

Professional Reference 3

AUTHORIZATION & RELEASE FOR REFERENCES

WANT TO KNOW IF SIS NW CAN MAKE A DIFFERENCE?

Portland

Seattle

WANT TO STAY UPDATED ON THE LATEST WAYS SIS NW CAN MAKE A DIFFERENCE?