Apply | Big Green Umbrella Media

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EQUAL ACCESS TO PROGRAMS, SERVICES AND EMPLOYMENT IS AVAILABLE TO ALL PERSONS. THOSE APPLICANTS REQUIRING REASONABLE ACCOMMODATION TO THE APPLICATION AND/OR INTERVIEW PROCESS SHOULD NOTIFY A REPRESENTATIVE OF THE HUMAN RESOURCES DEPARTMENT.

Position(s) applied for*

Referral Source*

Employee

Other

Name*

First Middle Last

Address*

Street Address City State ZIP Code

Email*

Phone*

If necessary, the best day of week to call you is*

Best time of day to call is*

Have submitted an application here, or been employed, before?*

Yes

If yes, give date(s) and position(s)

Are you legally eligible for employment in this country?*

Yes

Date available for work*

What is your desired compensation range?*

From ($)

To ($)

Type of employment desired*

Full-time

Part-time

Internship

Will you relocate if job requires it?*

Yes

Will you travel if job requires it?*

Yes

Are you able to meet the attendance requirements?*

Yes

If no, please explain

Will you work overtime if required?*

Yes

If no, please explain

Have you ever filed for bankruptcy?*

Yes

If yes, give date(s)

Do you smoke cigarettes?*

Yes

If yes, how many packs per day?

Have you ever pled "guilty" or "no contest" to, or been convicted, of a crime?*

Yes

If yes, please provide date(s) and details

ANSWERING “YES” TO THESE QUESTIONS DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT. FACTORS SUCH AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION, REHABILITATION AND POSITION APPLIED FOR WILL BE TAKEN INTO ACCOUNT.

Driver's License number (if driving is an essential job function)

Issuing State

State

Employment History

Starting with your most recent employer, provide the following information for your last 3 jobs.

Employer Name

Phone

Address

Street Address City State ZIP Code

Employed From

Employed To

Starting Job Title

Final Job Title

Immediate Supervisor

Name

Title

May we contact him or her for reference

Yes

Later

Starting Compensation

Hourly

Salary

Provide the value that applies to you.

Final Compensation

Hourly

Salary

Provide the value that applies to you.

Reason for leaving

Employer Name

Phone

Address

Street Address City State ZIP Code

Employed From

Employed To

Starting Job Title

Final Job Title

Immediate Supervisor

Name

Title

May we contact him or her for reference

Yes

Later

Starting Compensation

Hourly

Salary

Provide the value that applies to you.

Final Compensation

Hourly

Salary

Provide the value that applies to you.

Reason for leaving

Employer Name

Phone

Address

Street Address City State ZIP Code

Employed From

Employed To

Starting Job Title

Final Job Title

Immediate Supervisor

Name

Title

May we contact him or her for reference

Yes

Later

Starting Compensation

Hourly

Salary

Provide the value that applies to you.

Final Compensation

Hourly

Salary

Provide the value that applies to you.

Reason for leaving

Skills and Training*

Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

Education

Starting with the most recent school you attended, provide the following information.

School Name

Address

City State

Number of Years Completed

Achieved

GED

Diploma

Degree

GPA

Major

Minor

School Name

Address

City State

Number of Years Completed

Achieved

GED

Diploma

Degree

GPA

Major

Minor

School Name

Address

City State

Number of Years Completed

Achieved

GED

Diploma

Degree

GPA

Major

Minor

References*

Name

Title

Business

Phone

# of Years Known

List name and telephone number of three business/work references who are not related to you. If not applicable, list three school or personal references who are not related to you.

Additional Information

Organization

Offices held

List professional, trade, business or civic associations and any offices held: EXCLUDE MEMBERSHIPS THAT WOULD REVEAL RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, CITIZENSHIP, AGE, MENTAL OR PHYSICAL DISABILITIES, VETERAN/RESERVE NATIONAL GUARD OR ANY OTHER SIMILARLY PROTECTED STATUS.

List special accomplishments, publications, awards, etc.

EXCLUDE MEMBERSHIPS THAT WOULD REVEAL RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, CITIZENSHIP, AGE, MENTAL OR PHYSICAL DISABILITIES, VETERAN/RESERVE NATIONAL GUARD OR ANY OTHER SIMILARLY PROTECTED STATUS.

List any additional information you would like us to consider

Document Upload

Max. file size: 32 MB.

Attach your resume or cover letter if applicable

APPLICANT STATEMENT*

I certify that all information I have provided in order to apply for and secure work with Big Green Umbrella Media, Inc. is true, complete and correct.

I expressly authorize without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), 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 hereby 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 in the employment process and all other persons, corporations or organizations for furnishing 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.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with our 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 an 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 also 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 understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer’s service, whenever it is disclosed.

I AGREE

Signature*