Application for Employment — Morrison Dental Group, Williamsburg, Chincoteague, Norge, Virginia, USA

Application for Employment

Prospective Employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin or handicap.  We are an equal opportunity employer.

Click here for a printable PDF file of the employment application that you can complete and return to us with your resume.

To apply online, complete the application below and then click the "Submit" button at the end. Some fields are required and are marked with an asterisk.

Date *
Date
PERSONAL INFORMATION
Name *
Name
Address *
Address
Home Phone *
Home Phone
Cell Phone
Cell Phone
Business Phone
Business Phone
What was your previous address?
What was your previous address?
Are you over 18 years of age? *
Have you ever applied for employment with us? *
Are you legally eligible for employment in the United States? *
Are you employed now? *
If you are employed now may we inquire of your present employer?
Have you been convicted of a crime in the last ten years? *
Answer "no" for misdemeanors or convictions which have been annulled, expunged or sealed by a court. If yes, describe in full below.
Any reasons why you might not be able to perform the job duties (with reasonable accommodation)? *
If yes, please explain below:
Any driving violations?
EDUCATION
Name, location of school, course of study, years completed, and any degree diploma
Did you graduate? *
Name, location of school, course of study, years completed, degree diploma
Did you graduate?
Name, location of school, course of study, years completed, and any degree diploma
Did you graduate?
MILITARY
Complete this section if you served in the U.S. Armed Forces.
EMPLOYMENT HISTORY
Phone
Phone
Address
Address
Phone
Phone
Address
Address
Phone
Phone
Address
Address
RESUME OR ADDITIONAL INFORMATION OR COMMENTS
REFERENCES
Below list three persons not related to you whom you have known at least one year.
I understand that typing my name below and clicking the "submit" button constitutes my signature on this application. I also verify that the information provided in this Application for Employment is true, correct and complete. If employed, any misstatements or omissions of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history, I authorize you to do so. If a report is obtained you must provide, at my request, the name and address of the agency so I may obtain from them the nature and substance of the information contained in the report.