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Employment Application

>>>Employment Application
Employment Application 2023-07-20T15:00:05-07:00

Application for Employment

Instructions: Please fill out application completely; an incomplete application may disqualify you. Employment is contingent on the successful completion of a background check. You will be contacted if you are selected for an interview. You will be required to provide legal proof of your authorization to work in the United States within 3 days, if you are hired. Employment is contingent upon providing the required documentation. If you require any accommodation to complete the application or interview process, please call the WAPC Administration at (206) 517-2350.

PERSONAL DATA

Name(Required)
Address(Required)
Are you age 18 or older?(Required)
Are you eligible to work in the U.S.?(Required)

POSITION DETAILS

Work Availability(Required)
Select date MM slash DD slash YYYY

WAIVER

I understand that employment is contingent on the successful completion of a background check, and if hired by the Washington Poison Center, my employment will be of indefinite duration. The Washington Poison Center or I will be free to terminate this employment relationship at will and at any time. I further understand that any representations to the contrary are unauthorized and void, unless contained in a formal written employment contract signed by an officer or administrator of the Washington Poison Center. I certify that the information set forth in this application is true and complete to the best of my knowledge. I understand that, if employed, I will be subject to immediate dismissal if I have made any false statements, misrepresentations, or provided incomplete information in this application. I authorize the Washington Poison Center to check all information contained in or related to this application, including employment references, records of law enforcement agencies, educational institutions and licensing agencies. I release the Washington Poison Center and any individuals or organizations providing references or background information from any liability arising out of giving or receiving of such information.
Signature(Required)
By typing my name on the signature line above I attest that the information entered is true and accurate to the best of my knowledge and belief.
MM slash DD slash YYYY

WORK EXPERIENCE

Employer Name and location
Position
Title
Dates Employed: From
To
Hours per week
Reason for leaving
Current supervisor name:
May we contact them?
If yes, contact email:
Please account for any time gaps in employment, including any military service.
0 of 200 max characters
A resume or CV is required for all professional positions.
Accepted file types: pdf, Max. file size: 50 MB.