Instructions:Please complete and print this page. Sign in ink and fax it to
952-829-5429. Required fields are noted with asterisks (*).
Personal Information
Social Security Number*
First Name*
M.I.
Last Name*
Street Address*
City*
State*
Zip*
Home Phone*
Work Phone
Alt. Phone
Email Address
Education/Training
Highest level of
education
Last grade
completed
Licenses/certifications held
Schools/Colleges Attended
Course of Study
Diploma, Degree, or
Certificate
Work
Experience
Please list jobs held in the past ten
years. List most recent first.
Employer & Location
Position/Title
Dates Employed
Reason for Leaving
References
Please list references who may be contacted
regarding your work history. Include all managers &
supervisors at the last two employers who evaluated or
supervised your performance.
Name*
Firm *
Mailing Address
Position/Title*
Phone Num.*
Other
Information
Have you ever been convicted of,
plead guilty or no contest (nolo contendre) to, or received
probation, suspension, or deferred adjudication for
a misdemeanor or felony involving moral turpitude (includes,
but is not limited to: dishonesty, fraud, deceit, theft,
misrepresentation, deliberate violence, offense of a sexual
nature, drug or alcohol related offenses, or acts of abuse)?
If yes, please state where, when, and the nature of the
offense:
(A misdemeanor or felony conviction
is not an automatic bar to employment. We will
consider the nature, date, and relationship between the
offense and the position for which you are applying.)
Verification
I hereby affirm that all the information provided in
this application is true and accurate to the best of my knowledge and
understand that any deliberate falsifications, misrepresentations, or
omissions of fact may be grounds for rejection of my application or
dismissal from subsequent employment.
I authorize the references listed above to give you any and all
information concerning my previous employment and any pertinent
information they may have, personal or otherwise, and release all such
parties from any liability for any damage that may result from
furnishing the same to you.
I authorize Par3/IT to request a personal background
check from a 3rd party of their choosing. I understand that the
background check may include data concerning my places of residence,
criminal history, civil judgments, and my personal credit history.
I understand that Par3/IT will use this information solely for the
purposes of extending or not extending an offer for employment. I also
understand that Par3/IT will not sell or share this information with any
other entity and will destroy all copies of this information within 30
days of this signed application.
Par3/I.T. Standard Employment Application
