THIS IS NOT AN ACTUAL JOB APPLICATION. This online application is provided for those unfamiliar with the process to practice the necessary skills (filling in boxes, looking for error messages, correcting mistakes, etc.)

General Information
Personal Information
Name & address of school
Degree obtained
Semester/Quarter hours
Major course work

A resume of your employment record will not be accepted in place of the requested employment information. Starting with your current job, list your last three (3) employers since age 18. If your last three (3) employers do not cover a period of ten (10) years, list previous employers, including self-employment, military service and volunteer work, to account for ten (10) years of employment. Use an additional sheet if necessary. Account for all periods of unemployment, but if you were unemployed because of medical reasons, do not give any specific information - just state "medical." A resume may be included as a supplement to the application.

Phone number
Years known

READ THE FOLLOWING STATEMENT BEFORE SUBMITTING YOUR APPLICATION: I hereby certify that all statements made on this application are true and complete to the best of my knowledge and belief. I understand and agree that any misstatements or omissions of material facts herein may cause an offer of employment made by the Organization to be withdrawn or my employment with the Organization terminated. I further understand that all information provided herein is Public Record and is subject to review upon request. I authorize the organization to conduct a thorough investigation of my references and past employment and to conduct background checks consisting of the following: credit, criminal and driver’s license, and any other job-related certifications. I understand that if an offer of employment is made to me, I may be required to submit to a physical examination and a review of my medical history. Accordingly, I authorize those parties having knowledge of my past (including financial and credit records) to cooperate in this procedure by releasing information as requested. I respectfully request that former employers furnish the necessary information concerning my employment with their organization and I hereby release them from any and all liability for damages for providing information requested. I do acknowledge and accept that under Tennessee Law any information, with the exception of medical, will become public record upon receipt by the Organization. I hereby waive any rights or claims I may have whether presently fully developed or not, against the organization or its agents or employees, arising out of, or resulting from the release, authorized or unauthorized, of the information received pursuant to or in connection with the Organization handling, processing, investigation, etc. of my application for employment with the Organization. I understand that this investigation will be conducted prior to my being given a job offer or within 90 days of employment. If I am hired, I agree to conform to the rules and regulations of the organization set forth in the organization's personnel policies & procedures and acknowledge that these rules and regulations may be changed by the Organization at any time, at the organization's sole option and without any prior notice to me. I acknowledge that if I am employed, my employment will be at-will and may be terminated with or without cause at any time by me or by the Organization. I agree to conform to the organization's drug-free workplace policy and agree to submit to drug tests as required by the Organization. Notice to applicants: Screening tests for illegal drug use may be required as a condition of employment.

Pre-Employment Background Investigation Consent Form

The undersigned, referred to as “Applicant”, hereby authorizes the organization either directly or through its agent to investigate Applicant’s background. This may include information as to character, financial responsibility, criminal and/or civil records. Records from public and private sources may be reviewed concerning criminal history, civil court cases, credit history and references. Applicant acknowledges that a fax or photographic copy shall be as valid as the original. Applicant further understands that a complete disclosure of the nature and scope of this investigation may be obtained by a written request received within ninety days. The information below is required to obtain requested records and must be completed by all Applicants. The organization requests this information for the sole purpose of facilitating the investigation of Applicant. Certain information provided herein by Applicant will not be considered or used by the organization in determining whether Applicant will be accepted as an employee. This information is denoted below by an asterisk (*).

I hereby authorize, without reservation, any law enforcement agency, company, institution, credit bureau, or references contacted by the organization or its agent, to furnish the information described above.