Treasure Tutorial Services, Incorporated

PO BOX 1844
Garner, North Carolina 27529

AN EQUAL OPPORTUNITY EMPLOYER

It is policy of Treasure Tutorial Services, Incorporated to provide employment opportunities without regard to race, color religion, ex, national origin, age, handicap, or veteran status.

APPLICATION FOR EMPLOYMENT

IMPORTANT: Please fill in your response above each line unless otherwise indicated. All answers must be printed or typed. Answers that are illegible or incomplete may prevent us from considering your application.

PERSONAL DATA

                                 

FIRST NAME                                               MIDDLE                                                LAST                                               

                                                    

PRESENT ADDRESS FULL                    CITY                                                STATE                 ZIP                     TELEPHONE

                                                    

PERMANENT ADDRESS(IF DIFFERENT)        CITY                            STATE                 ZIP                     TELEPHONE

  Yes No                                                                  

ARE YOU LEGALLY AUTHORIZED                       YOUR VISA TYPE IF AVAILABLE                                           VISA# AND EXPIRATION DATE

TO WORK IN THE UNITED STATES

____________________________________________________________________________________________________________________________

EMAIL ADDRESS

DO YOU HAVE A VALID DRIVER LICENSE?    YES   NO

HAVE YOU EVER BEEN CONVICTED OF OR SENTENCED FOR ANY VIOLATION OF THE LAW?

  YES   NO

IF YES, GIVE FULL PARTUCULARS.

(THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT):

POSITION INFORMATION

POSITION APPLIED FOR

ARE YOU WILLING TO WORK NIGHTS AND WEEKENDS?   YES   NO

EDUCATION

LAST HIGH SCHOOL ATTENDED/COMPLETE ADDRESS

ATTENDED FROM to                                        GRADUATED?   YES   NO

COLLEGE OR UNIVERSITY/COMPLETE ADDRESS

ATTENDED FROM to                                        GRADUATED?   YES   NO

MAJOR          DEGREE RECEIVED

COLLEGE OR UNIVERSITY/COMPLETE ADDRESS

ATTENDED FROM to                                        GRADUATED?   YES   NO

MAJOR          DEGREE RECEIVED

LIST ANY SCHOLARSHIPS, ACADEMIC HONORS, AWARDS OR SPECIAL ACHIEVEMENTS:

 

IN WHAT LANGUAGES OTHER THAN ENGLISH CAN YOU CONVERSE?

   FLUENT?    YES   NO

   FLUENT?    YES   NO

   FLUENT?    YES   NO

   FLUENT?    YES   NO

EMPLOYMENT HISTORY

IMPORTANT: STARTING WITH YOUR PRESENT OR MOST RECENT EMPLOYER, LIST IN CONSECUTIVE ORDER ALL EMPLOYMENT AND PERIODS OF UNEMPLOYMENT SINCE YOU GRADUATED FROM OR LAST ATTENDED HIGH SCHOOL. ADDITIONAL EMPLOYMENT MAY BE LISTED ON A SEPARATE PAGE(S) IF NECESSARY.

PRESENT OR MOST RECENT EMPLOYER

                           /                           to

FULL NAME OF COMPANY                TELEPHONE                        SALARY BEGIN/END                                         EMPLOYED FROM/TO

                                                                                                                                                       

                                           

STREET ADDRESS                                                      CITY                                        STATE                 ZIP CODE

NAME & TITLE OF SUPERVISOR

                    

TITLE OF YOUR POSITION                                                                        DEPARTMENT

DUTIES

REASON FOR LEAVING

PREVIOUS EMPLOYER

                           /                         to
FULL NAME OF COMPANY                TELEPHONE                        SALARY BEGIN/END                                         EMPLOYED FROM/TO
                                           

STREET ADDRESS                                                      CITY                                        STATE                 ZIP CODE

NAME & TITLE OF SUPERVISOR

                    

TITLE OF YOUR POSITION                                                                        DEPARTMENT

DUTIES

REASON FOR LEAVING                                                              

PREVIOUS EMPLOYER

                           /                          to
FULL NAME OF COMPANY                TELEPHONE                        SALARY BEGIN/END                                         EMPLOYED FROM/TO
                                           

STREET ADDRESS                                                      CITY                                        STATE                 ZIP CODE

NAME & TITLE OF SUPERVISOR

                    

TITLE OF YOUR POSITION                                                                        DEPARTMENT

DUTIES

REASON FOR LEAVING                                                              

OTHER INFORMATION

HAVE YOU EVER BEEN SUSPENDED, PLACED ON PROBATION, ASKED TO RESIGN, DISCHARGED, OR TEMINATED?    YES   NO

IF YES, EXPLAIN:

SKILLS

CHECK AREAS IN WHICH YOU CAN TUTOR (PROVIDE YEARS OF EXPERIENCE IF APPLICABLE):

ENGLISH             PRE-ALGEBRA         STATISTICS 

SPANISH                ALGEBRA                 HISTORY    

BIOLOGY              ALGEBRA II             OTHER        

PHYSICS                 GEOMETRY       

CHEMISTRY          CALCULUS         

MATH (K-6)            TRIG.                  

INTERGRATED MATH (I, II, III, OR IV)

APPLICANT'S CERTIFICATION AND AGREEMENT

I HEREBY CERTIFY that my answers to the foregoing questions are true and complete that I have not knowingly withheld any facts, circumstances or other information which would, if disclosed, affect my application.  I further understand that any false or misleading statement or omission for pertinent information will result in the rejection of my application, or in dismissal if discover subsequent to my employment.

I HEREBY AFFIRM that by execution of the application, I acknowledge that the Company has disclosed to me that an Investigative Consumer Report, including information as to my character, general reputation, personal characteristics, and mode of living may be made; and that I, upon written request to the Company made within a reasonable time after the date of this application, may obtain a complete and accurate disclosure of the nature and scope of the investigation requested.

I HEREBY AUTHORIZE the Company to request, and I ALSO AUTHORIZE AND REQUEST each former employer, school attended, and each person, firm, or cooperation given as references above, to furnish at any time, any information which may be sought concerning me any my work habits, character or skill, and any other data required, whether in connection with this application or for the purpose of complying with surety company requirements or otherwise.

I HEREBY AFFIRM that by submitting this application I agree to submit to medical evaluations and/or examinations, including tests for the presence for illegal drugs or alcohol, prior and during employment, within a time period prescribed by the Company and as often as directed during employment.

I HERBY AUTHORIZE the medical examiner to disclose to the Company any and all findings and conclusions arrived at in any examination performed either prior to employment or during employment.

I UNDERSTAND that I should be given employment, such employment shall be for an indefinite period of time and may be terminated, at will, at anytime, for any reason, by the Company without notice or without liability whatsoever, except for unpaid wages or salary earned by the date of termination. I further understand that only the President of the Company has the authority to enter into any agreement for employment for a specified period of time or to make any agreement contrary to this at will standard and that any such agreement must be in writing.

I UNDERSTAND that if I am employed, terms and conditions of my employment will be governed by this application and the Company's Terms of Employment and Policy and Procedures, as amended from time to time by the Company.

The Company operates under the principles of affording equal employment opportunity through affirmative action for qualified handicapped individuals, qualified veterans if the Vietnam era and qualified disabled veterans.

All applicants and employees who believe themselves to be members of one or more for these groups, and who wish to identify themselves as such for the purpose of affirmative action consideration are invited to do so.

Submission of this information is voluntary and refusal to provide it will not subject you discharge or disciplinary treatment.  Information obtained concerning individuals shall be kept confidential, except that, (1) supervisors and managers may be informed regarding disabled veterans and handicapped individuals, as necessary, (2) first aid and safety personnel may be informed, when and to the extent appropriate, if the condition might require emergency treatment, and (3) governmental officials investigating compliance will be informed.

I wish to volunteer the following information (check one):    I do not qualify
                                        I do qualify under the following:    Handicapped
                                                                                Vietnam Era Veteran
                                                                        Disabled Veteran

Thank you for completing this application.  It will remain under consideration for six months.  It will not be necessary for you to reapply during this six month period.  Your interest in Treasure Tutorial Services Incorporated is appreciated.