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XzamCorp Online Application

GENERAL INFORMATION


First Name*

Last Name*

Your Email*

CONTACT DETAILS


Street Address*

APT#

City*

State*

Zip Code*

Primary Phone*

Secondary Phone

Best Time To Contact You?

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TRAINING AND EDUCATION


Highest Level of Education*

Colleges / Other Training

Other Personal Achievements

SKILLS


Select Any That Apply:

BACKGROUND INFORMATION


Do you have a valid Ohio State Driver License?

Desired job type:

Work status:

EMPLOYMENT HISTORY


Employer Name*

Employer Address*

Employer Phone*

Hours worked/week*

Position and Wage*

Supervisor Name & Phone*

Primary duties*

Reason for leaving*

Date Employed From*

To*

Employer Name

Employer Address

Employer Phone

Hours worked/week

Position and Wage

Supervisor Name & Phone

Primary duties

Reason for leaving

Date Employed From

To

Employer Name

Employer Address

Employer Phone

Hours worked/week

Position and Wage

Supervisor Name & Phone

Primary duties

Reason for leaving

Date Employed From

To

PROFESSIONAL REFERENCES


Please list below any other individuals you would like to responsibly evaluate your work performance and/or character.

Name*

Place of employment / title*

Phone*

Name

Place of employment / title

Phone

Name

Place of employment / title

Phone

PERSONAL INFORMATION


Briefly describe your perceptions about what constitutes great customer service / satisfaction.*

What do you enjoy doing outside of work?*

Electronic Signature Agreeing To The Terms Written Below


All the foregoing is true and accurate to the best of my knowledge. I understand that employment with or being an independent contractor of XzamCorp is “at-will” which means that the relationship may be terminated at any time, with or without prior notice. I authorize XzamCorp to solicit information regarding my criminal record, credit rating, employment history and similar background information, and to contact all references. I release all parties and person connected with any such request from all claims, liabilities and damages.

First, Middle and Last Name*

Today's Date*

I have read and understand the above terms and agree to them.*

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