Format Legend: Phone number Format example:7404538976
Date Format example:12/26/2007 month/day/year
Social Security Number:123456789

APPLICATION FOR EMPLOYMENT

Name Last Name
First name
Middle
Date

Address Street
City
State
Zip Code
County of Residence

Phone Main Phone(area code)
Other Phone(area code)
Social Security Number

U.S Citizen
Yes
No

Are You At Least 18 years of Age
Yes
No

Hear About How did you hear about this Company?

Position Position Applied For
Wage Expected
Date Availabe

Shift Applying For Please Select Schedule Availability

Previous Dates Applied Have you ever applied for employment with ITM
Yes
No
(if yes fillout below)
Date
Location
Position

Relatives Do you have relatives employed by ITM MARKETING, INC
Yes
No
(if yes, state name and relationship of the relative employed.)

Ever been convicted of felony - if yes please explain Have you ever been convicted of a felony?
Yes
No
If yes complete the following
Date
Location
Nature Of Offense

EDUCATION

High School Name and address of school
Major Subject
Select Last Year Attend
Graduated

College Name and address of school
Major Subject
Select Last Year Attend
Graduated

Graduate School Name and address of school
Major Subject
Select Last Year Attend
Graduated

Business Trade, Other Name and address of school
Major Subject
Select Last Year Attend
Graduated

Other Specialized Training Skills (i.e, Computers, etc.) Name
Location
From|To
Did you graduate
Diploma, Certificate, Etc.

Membership

Membership in professional, civic, social, or honorary organizations(exclude those which disclose your race, color, religion or national origin)

Additional Experience Or Qualificatios

List any other experience, skills or other qualifications including hobbies, which you believe should be cosidered in evaluating your qualifications for employment. Please indicate any prior military service which would be considered in connection with your application for employment

WORK EXPERIENCE(ONLY FOR LAST 10 YEARS)

Company 1 COMPANY(Name)
TELEPHONE #(include area code)
BUSINESS ADDRESS
DATE OF EMPLOYMENT (month and year) FROM|TO
JOB TITLE
SUPERVISOR'S NAME
REASON FOR LEAVING
BRIELFY DESCRIBE YOUR DUTIES

Company 2 COMPANY(Name)
TELEPHONE #(include area code)
BUSINESS ADDRESS
DATE OF EMPLOYMENT (month and year) FROM|TO
JOB TITLE
SUPERVISOR'S NAME
REASON FOR LEAVING
BRIELFY DESCRIBE YOUR DUTIES

Company 3 COMPANY(Name)
TELEPHONE #(include area code)
BUSINESS ADDRESS
DATE OF EMPLOYMENT (month and year) FROM|TO
JOB TITLE
SUPERVISOR'S NAME
REASON FOR LEAVING
BRIELFY DESCRIBE YOUR DUTIES

Notifation And Agreement (Please Read Before Signing)

I CERTIFY ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE. I UNDERSTAND THAT THE FALSIFICATION,MISREPRESENTATION OR OMMISSION OF FACT ON THIS APPLICTION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION REGARDLESS OF WHEN OR HOW DISCOVERD. Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed. It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, and any other characteristic protected by Federal, State or Local law. I authorize the investigation of all statements and information contained in this allocation, I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation. If hired, I agree to abide by all of the Company rules and regulations, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the Company or me. I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment. I understand that the Company and all Plan Administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. Except for the President in a signed document, no representative or agent of the company has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term of condition of employment. I acknowledge that I have read and understand the above statements and hereby grand permission to confirm the information supplied on this application by me.

Applicant Name
Date

Consumer Report Authorization

Undersigned hereby authorizes ITM Marketing Inc., to obtain an and all consumeer reports bearing on my creditworthiness,credit standing, credit capacity, character, general reputation, personal characteristics or mode of living for the purpose of serving as a factor in determining my eligibility for employment. This authorization permits the employer to obtain any and all information from any and all sources, including but not limited to, credit bureaus, driving and license records, criminal histories, drug test, and past employmnet information. I agree that the employee, ITM Marketing., may use consumer reports for any and all employment purposes.

Dated
Signature