Employment Application
Please fill out the information below and submit the employment application.
Sign in to Google to save your progress. Learn more
Name (Last, First, Middle) *
Address, City, State, Zip *
Phone Number
Email Address *
Availability
Are you authorized to work in the U.S. on an unrestricted basis? *
Have you ever been convicted of a felony? *
If yes, please explain. *
Please share any experience or education that you have that helps you qualify for this job.
List three references not related to you with name and phone number and relationship type. *
Work history #1: Starting with your most recent job, fill out the employment details. (Company name, supervisor name, duties, phone number)
Work history #2:  (Company name, supervisor name, duties, phone number)
Work history #3: (Company name, supervisor name, duties, phone number)
I hereby authorize Michael or Mary Collins (Michael J. Collins, Inc.) and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records. *
I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to Mike or Mary Collins (Michael J. Collins, Inc.) or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Mike or Mary Collins (Michael J. Collins, Inc.) and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth. *
Please check the box below if you wish to receive a copy of your background check.
I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application. I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party. *
Required
Applicant Signature: Type your full name in the box as your electronic signature. *
Please text a picture of your driver's license to Charlie Collins at (405) 534-8756 in order for us to complete your background check.  We will also need your social security number and you can either text that as well or call Charlie at the same number above.
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This content is neither created nor endorsed by Google.