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Detected region: United States of America

Employment Application

General Information
Application Information
Name
Address
Are you 18 or older?
Have you or your friends/family ever worked for this company?
Work Availability
Have you ever been convicted of a criminal offense or are you presently charged with a felony?*
*A criminal record or charges pending against you will not necessarily be a bar to employment, but is reviewed on a case by case basis for the position applied for.
Education
High School
Address
Grade Completed
College/Trade School
Address
Military Service
Previous Employment
Employer 1
May we contact your previous supervisor for a reference?
Employer 2
May we contact your previous supervisor for a reference?
Employer 3
May we contact your previous supervisor for a reference?
Professional References
Reference 1
Reference 2
Reference 3
Disclaimer and Signature
I certify that all information furnished on this application is true, complete, and correct. I understand and agree that any falsification, misrepresentation, misleading statement or omission of fact on either this application or during the pre-hire process (including falsification of information on a submitted resume) will be sufficient reason for my not being offered employment or to be dismissed at any time from Garrison Dental Solutions LLC [Garrison], if employed. I understand that neither completion of this application nor any other part of my consideration for employment establishes any obligation for Garrison to hire me. I also understand that if offered employment, it will be “at-will”, where my employment and compensation is for no definite period and may be terminated at any time by me or Garrison with or without cause and without previous notice. I acknowledge that no company employee has the power to enter in agreement for employment for any specified amount of time, or to make any agreements contrary to any of the above unless it is in writing and authorized by the company’s President. As a condition of employment, I agree to a 180-day statute of limitations for all employment-related claims.
One file only.
4 MB limit.
Allowed types: pdf, doc, docx, rtf.