Application


APPLICATION FOR EMPLOYMENT

Please check website for career opportunities No phone calls please in order to minimize delays for interviewing candidates. Applications are maintained on file for a maximum of ninety days, unless otherwise noted.

PACE OF THE TRIAD is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, disability or any other characteristic protected by Federal, State or local law or regulation. PACE OF THE TRIAD facility is tobacco free. A pre-employment drug screen may be required.

ANSWER ALL QUESTIONS

Please Select:*

Application Date (YYYY-MM-DD) *

Date Available (YYYY-MM-DD) *

Position Preferred *

Salary Required*

Name: (Last, First, Middle) *

Maiden:

Address:

Street:*

City*

State*

Zip Code:*

Telephone: (999-999-9999)*

Other Telephone: (999-999-9999)

Email:

Are you over the age of 18 years? *

(If no, you may be required to provide authorization to work)

Are you authorized to work in the United States?

Military Service:

Were you a member of the U.S. Military Services? *

If yes, give type of discharge:

Date of Discharge: (YYYY-MM-DD)

Note: A dishonorable or general discharge is not an absolute bar to employment

EMPLOYMENT HISTORY(List present/most recent employer first)

Employer #1:

Company/Agency Name:

Full-time or Part-time:

Dates Employed:

From: (YYYY-MM-DD)

To: (YYYY-MM-DD)

Salary/hourly rate:

Street Address:

City:

State:

Zip:

Name of Supervisor:

Phone Number: (999-999-9999)

Your Job Title:

Your Duties:

Reason for leaving:

Employer #2:

Company/Agency Name:

Full-time or Part-time:

Dates Employed:

From: (YYYY-MM-DD)

To: (YYYY-MM-DD)

Salary/hourly rate:

Street Address:

City:

State:

Zip:

Name of Supervisor:

Phone Number: (999-999-9999)

Your Job Title:

Your Duties:

Reason for leaving:

Employer #3:

Company/Agency Name:

Full-time or Part-time:

Dates Employed:

From: (YYYY-MM-DD)

To: (YYYY-MM-DD)

Salary/hourly rate:

Street Address:

City:

State:

Zip:

Name of Supervisor:

Phone Number: (999-999-9999)

Your Job Title:

Your Duties:

Reason for leaving:

Employer #4:

Company/Agency Name:

Full-time or Part-time:

Dates Employed:

From: (YYYY-MM-DD)

To: (YYYY-MM-DD)

Salary/hourly rate:

Street Address:

City:

State:

Zip:

Name of Supervisor:

Phone Number: (999-999-9999)

Your Job Title:

Your Duties:

Reason for leaving:

OTHER INFORMATION: Have you ever been convicted of, pled guilty or no contest to, a misdemeanor (last 3 years) or felony (last 7 years), other than minor traffic violations? A conviction is not an automatic disqualification for employment.

Have you ever been convicted of a crime including sex-related or child abuse related offenses? *

If yes, to any describe in full, including date(s).

Auto Insurance Company:

Have you had more than 3 moving violations or more than one chargeable accident within the past three years? *

Professional: *

Are you registered in North Carolina? *

State of Registration:

Year Original License or Certification:

License or Certification #:

Expiration Date: (YYYY-MM-DD)

Has your license or certification ever been revoked, suspended or denied in any state? *

If yes, what state?

Is your license or certification currently under investigation? *

If yes, please explain:

Technical:

Typing Speed (wpm):

Which of the following are you able to use proficiently? (Check all that apply)
CalculatorFaxVoice MailCopy MachineWORDEXCELPOWER POINTACCESSStructured Query Language(SQL)DatabasePublisher

Education:

High School/GED:

Name: *

Last Year Completed: *

Did you Graduate? *

Degree/Certificate:

College/Technical:

Name:

Last Year Completed:

Did you Graduate?

Degree/Certificate:

Graduate Studies:

Name:

Last Year Completed:

Did you Graduate?

Degree/Certificate:

Are you attending school now?

Course of Study:

Expected Graduation Date: (YYYY-MM-DD)

References (Please give complete and current information below for at least three references.) Two references must be a former or current employer.

Company/Agency #1:

Supervisor:

Phone Number (999-999-9999):

Company/Agency #2:

Supervisor:

Phone Number (999-999-9999):

Company/Agency #3:

Supervisor:

Phone Number (999-999-9999):

May we contact your present employer? *

Employment Disclosure:
I certify that my answers herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that any false, misleading, or incomplete information given during my application or interview (s) may result in denial of employment or in the termination of employment. I authorize PACE OF THE TRIAD to check my references and to verify information contained on this application. Further, I authorize former employers, personal references and others to give my information concerning me requested by PACE OF THE TRIAD, whether or not it is in their records, and I hereby release them from any liability whatsoever.
By completing this application for employment with PACE OF THE TRIAD, I acknowledge that if employed I will be covered by the Company’s Alternative Dispute Resolution Program, and agree to accept this Program as a condition of my possible employment. I also understand that a copy of this Program may be obtained by contacting PACE OF THE TRIAD at (336) 550-4040.
I understand that if I receive an offer of employment, I may be required to take a drug screen and/or physical abilities test. I understand that the offer and my continued employment may be contingent upon completed references, successful completion of these and any other required post-offer screens, and that I am required to abide by all rules and regulations of the employer. This application for employment shall remain active for 6 months.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with PACE OF THE TRIAD is of an “at will” nature, which means that I may resign at any time and PACE OF THE TRIAD may discharge me at any time with or without cause. I further understand that this “at will” employment relationship may not be changed by any written document or by conduct unless an authorized executive of PACE OF THE TRIAD specifically acknowledges such change in writing.

EMPLOYMENT DISCLOSURE CONTINUED:
I understand that by applying for a position for which driving a company vehicle is a job requirement; the Motor Vehicle Record will be checked prior to an employment offer.
I understand that my employment may be contingent upon the receipt of an acceptable criminal history check received with my authorization. I understand that I may not be eligible for employment if I have had a felony conviction within the previous seven years and/or misdemeanor conviction in the previous three years involving violence, theft, and/or sexual misconduct.

Upload Resume:

Please sign by typing your full name in the field below: *

How did you learn about this particular job vacancy or what/who encouraged you to apply?

Please specify:

*Required fields