EMPLOYMENT APPLICATION


Please fill out all the required fields and attach your resume below.

Date of Application*
Name (first, middle, last)*
Address*
Are you 18 or older?*
Employment Desired*
Days You Are Available To Work*
Can you be available in the evenings?*
Can you relocate if the position requires it?*
Will you travel if the position requires it?*
How did you find out about this position?*
Have you ever worked for Life Impact International before?*
Have you ever used another name?*
Is any additional information relative to name changes, use of an assumed name, or nickname necessary in order to check on your work and education history?*
Have you ever been convicted of a felony?*
I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.*

Work History

Please list the names of your present or previous employers in chronological order with present or most recent employer listed first. Be sure to account for all periods of time. If self-employed, please give firm name and supply business references. Including a resume is also acceptable and can be done at the end of this application.

May we contact?*
Address
Date Employed - From*
Date Employed - To*
May we contact?*
Address
Date Employed - From*
Date Employed - To*
May we contact?*
Address
Date Employed - From*
Date Employed - To*
Have you ever been involuntarily terminated or asked to resign from any job?*

Education History

Did you graduate?
Did you graduate?
Did you graduate?
Did you graduate?

Business/Professional References

Please list three professional references of individuals who are NOT related to you.

1st Professional Reference*
2nd Professional Reference*
3rd Professional Reference*

Personal References

Please list three people who know you well.

1st Personal Reference*
2nd Personal Reference*
3rd Personal Reference*

Applicant Statement and Agreement

Please read and select "I agree" if you agree to each of the following statements below. If you do not agree with any of the statements please mark "I do not agree". If there is anything you do not understand, please contact our team at info@lifeimpactintl.org.

I hereby authorize Life Impact International to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to Life Impact International any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Life Impact International, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.*

Please read and select "I understand" if you understand and agree to each of the following statements below. If you do not understand and do not agree with any of the statements please mark "I do not understand". If there is anything you do not understand, please contact our team at info@lifeimpactintl.org.

If I am employed by Life Impact International, I understand that I am required to comply with all rules and regulations of Life Impact International. *
If hired, I understand and agree that my employment with Life Impact International is at-will, and that neither I, nor Life Impact International is required to continue the employment relationship for any specific term. I further understand that Life Impact International or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications. *
I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *
I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my 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 have read and agreed to all of the above terms.*
Name*
Date*

Resume

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