Athenica General Application

Job Application:

Full Name *

Address *

City *

State *

Zip *

Phone Number *

Email *

Are you legally authorized to work in the U.S.? *

Yes

No

Will you now or in the future require visa sponsorship? *

Yes

No

Position Information

Position Applied For: *

Desired Salary/Hourly Rate: *

Available Start Date: *

Employment Type: *

Full-Time

Part-Time

Temporary

Seasonal

Are you available to work weekends or evenings? *

Yes

No

Education

High School: *

Location *

College/University: *

Location: *

Degree/Certification: *

Year Completed: *

Employment History (Most Recent First)

1. Employer: *

Position *

Dates of Employment: *

Reason for Leaving: *

Supervisor Name & Contact: *

2. Employer: *

Position *

Dates of Employment: *

Reason for Leaving: *

Supervisor Name & Contact: *

Skills & Qualifications

Relevant Skills *

Certifications/Licenses: *

Languages Spoken: *

References (Provide at least two professional references)

Name: *

Relationship: *

Phone *

Email *

Name: *

Relationship: *

Phone: *

Email: *

Disclosure & Acknowledgement

New York City law prohibits discrimination based on age, race, gender identity, sexual orientation, disability, criminal history (unless job-related), and other protected categories. This employer complies with all applicable local, state, and federal laws.
Employment is contingent upon the successful completion of a background check and drug screening, conducted after a conditional offer of employment has been made, in accordance with applicable laws including the NYC Fair Chance Act.
I certify that the information provided is true and complete to the best of my knowledge. I understand that false statements may result in disqualification or termination.

Applicant Signature: *

Date: *