Employment application

Please fill out the application below. Please note that items marked with an asterisk are required for submission. In addition to the below employment application, please e-mail your resume to: anncovey@coveypt.com

Name *
Name
Address *
Address
Phone *
Phone
Date Available *
Date Available
Are you currently employed? *
If so, may we contact your current employer? *
Have you applied to CoveyPT before? *
Have you ever been employed by CoveyPT *
How did you hear about this position? *
Did you graduate? *
Did you graduate? *
Did you graduate?
Have you ever served in the U.S. armed services? *
Discharge Date
Discharge Date
Address of Employer *
Address of Employer
Date Started *
Date Started
Date Ended *
Date Ended
May we contact your supervisor? *
Supervisor Name *
Supervisor Name
Supervisor Phone
Supervisor Phone
Address of Employer *
Address of Employer
Date Started *
Date Started
Date Ended *
Date Ended
May we contact your supervisor? *
Supervisor Phone
Supervisor Phone
Reference Name *
Reference Name
Reference Name *
Reference Name
Have you ever been convicted of a felony? *
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and teh references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal state laws.
Today's Date *
Today's Date
Please send your resume to: anncovey@coveypt.com