Employment Application Employment Application Personal Information First name Last name Personal pronouns (optional) Address City State ZIP Home phone Cell phone Email Position Position applied for Desired pay range To Hourly or annually Hourly Annually How many hours can you work weekly? Employment desired SelectFull-time OnlyPart-time OnlyFull- or Part-time Can you work evenings/nights as needed? Yes No Can you work weekends as needed? Yes No Are you currently employed? Yes No Date available to begin work? Are you legally eligible to work in the U.S.? Yes No Do you have responsibilities other than work that will interfere with job requirements? Do you have any upcoming events that would require extensive time from work? Education & Training High School High School - Name of School High School - Location High School - Number of Years Completed High School - Major & Degree College or University College or University - Name of School College or University - Location College or University - Number of Years Completed College or University - Major & Degree Specialized Training, Trade School, etc. Specialized - Name of School Specialized - Location Specialized - Number of Years Completed Specialized - Major & Degree Other Education Other Education - Name of School Other Education - Location Other Education - Number of Years Completed Other Education - Major & Degree Please list your areas of highest proficiency, special skills, certifications or other items that may contribute to your abilities in performing the position applied for: Please list professional or trade associations that you belong to that are relevant to this position: Other Information Do you have a driver’s license? Yes No Do you have auto insurance? Yes No Do you have the use of a reliable car? Yes No Work Experience Please list your work experience beginning with your most recent job held going back 7-10 years. If you were self-employed, give firm name. Repeater Name of employer Name of last supervisor Your last job title Employment dates To Address City State ZIP Phone number May we contact this employer? Yes No Reason for leaving (be specific): List major job duties or responsibilities: plus1 Add Work Experience minus1 Remove Work Experience References Please list three professional references. Reference 1 Name Position Company Address Phone Email Reference 2 Name Position Company Address Phone Email Reference 3 Name Position Company Address Phone Email Resume & Cover Letter Resume upload Drop a file here or click to upload Choose File Maximum file size: 10MB Cover letter upload Drop a file here or click to upload Choose File Maximum file size: 10MB Please read carefully Reference Check Consent & Authorization Form I have applied for employment with the Pacific Education Institute (PEI) and have provided information about my previous employment. My signature below authorizes my former or current employers and references to release the contents of my employment record with their organizations and to provide any additional information that may be necessary for my application for employment to PEI, whether the information is positive or negative. I authorize PEI to investigate all statements made in my application for employment and to obtain any and all information concerning my former/current employment. This includes my job performance appraisals/evaluations, disciplinary action(s) if any, and all other matters pertaining to my employment history. I knowingly and voluntarily release all former and current employers, references, and PEI from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with PEI. This form may be photocopied or faxed, and these copies will be as effective as a release or consent as the original which I sign. Signature Clear Application Form Waiver In exchange for the consideration of my job application by the Pacific Education Institute (“PEI”), I agree that: Neither the acceptance of this application nor subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other organizational practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of PEI, or otherwise to change in any respect the employment-at-will relationship between them and the undersigned, and that relationship cannot be altered except by a written instrument signed by an officer of PEI. The undersigned or PEI may end the employment relationship at any time for any reasons, with or without cause. If employed, I understand that PEI may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I further understand that by submitting this application, I give PEI permission to verify that I meet legal age requirements and that I am legally eligible for employment in the United States. Signature Clear PEI is an equal employment opportunity employer. PEI will not discriminate or tolerate any discrimination against employees, applicants, or other persons having dealings with PEI because of age, gender, gender identity or expression, sexual orientation, marital status, religion, race, national origin, genetic information, physical or mental disability, Veterans status or any other basis prohibited by applicable federal, state or local law. We assure you that your opportunity for employment with PEI depends solely on your qualifications. Thank you for completing this application form and for your interest in PEI. reCAPTCHA Submit Application