Enter information concerning the specific position for which you seek employment
Annual salary requested
Date Available
NOTE: Positions of Public Trust (such as Moderate Risk Public Trust) are not considered clearances.
Check all that apply
Please list professional designations, technical certifications, training, patents, publications, computer skills related to the job sought.
Enter only years of consecutive service with no breaks.
Please add additional employment information, jobs, Bureaus or offices where you have worked at the State Department
FOR FLORIDA APPLICANTS ONLY
(An intentional tort is a civil wrong resulting from an intentional act. Examples of an intentional tort include assault, battery, false imprisonment, and intentional infliction of emotional distress.)
Please read the below carefully and then type in your initials next to each line item.
I authorize the Company to verify, in any manner, all statements made by me. The Company may, for example, interview former employers, co-workers, schools, references, or others and request information and supporting documentation such as transcripts and evaluations.
I authorize any and all former employers, references, or educational institutions to release all information relevant to my employment or education to the Company, without giving me prior notice.
I release from any liability or responsibility all persons, companies and corporations supplying any information in verifying my statements above, as well as the Company in connection with its obtaining such information for use in verifying my statements above.
I understand that the Company participates in the Electronic Employment Verification Program (E-Verify) and if hired, will provide the federal government with my Form I-9 information to confirm that I am authorized to work in the U.S.
I understand that the Company is a Drug Free Employer in compliance with its obligations and responsibilities as a Federal government contractor.
I shall preserve in strictest confidence all information regarding the business or customers of the Company that may be disclosed to me or come to my attention in the process of applying for a position with the Company.
If employed by the Company, I agree to comply with the Company's policies and procedures, safety rules, and cooperate in any reasonable security investigation. I understand that I am not employed by or entitled to employment by the Company unless and until I have received and accepted a written offer of employment from a Company representative. I also understand that no other act of the Company, including the acceptance of my application for employment, the scheduling of interviews with me, or any oral or written statements of interest or encouragement, creates an employment relationship with me, and I will not rely on any such act of the Company.
I understand that if I am employed by the Company, such employment is “at-will,” which means that my employment and related compensation may be terminated at any time, with or without cause, and with or without advance notice by me or by the Company.
I understand that any misrepresentation or omission of fact on this application, my resume, any supplementary materials submitted by me, and interview responses, may be cause for a refusal to hire me or the termination of employment at any time during the period of my employment.
I have reviewed this application personally, and I agree that all statements I have made on this application, in my resume, and other supplementary materials submitted by me are true and correct. I have not knowingly withheld any information that might adversely affect my chance for employment.
List three people (other than relatives) who are in a position to evaluate your previous employment performance, preferably former supervisors or people with whom you have worked. If applying for a supervisory position, please include one subordinate.
Enter full name, company, title, phone, and email
