Application for Employment (All)

By Tommy Johnson,2014-05-02 01:19
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    Employment Application

    It is the policy of Clear Channel not to discriminate in its employment and personnel policies because of a person’s sex age, race, religion, color, marital status, sexual orientation, citizenship status for legal residents, disability or national or ethnic origin, or other protected class.

Last Name First Middle

     Street Address

     City, State Zip Code Daytime Telephone Number

Are you legally eligible to work in the United States?

    All applicants will be required to furnish proof of identity and legal work authority within 3 business days of hire. Social Security Number: ___________________________________________ Check if you are under 18 years of age ;

Do you have a valid driver's license to operate an automobile in this state?

    Driver's License Number: ________________________________

    Are you insurable at standard rates to operate an automobile in this s


    Equipment/Machines you can operate and/or licenses you hold:


    Position you are applying for: ________________________ Check this box if you are applying generally

    What is your desired salary? __________________________

    How did you learn about this specific

Have you ever been previously employed with this company including all

    If yes, Date: From: ___/___/___ to ___/___/___ Location: _________________________

     Date: From: ___/___/___ to ___/___/___ Location: _________________________

     Date: From: ___/___/___ to ___/___/___ Location: _________________________ Are you available for full- If no, what hours/days can you work? __________________________

Are you subject to any contractual restrictions that would prevent, or interfere with, you accepting the position or performing the

    duties of this position?


High School 9 10 11 12 (Circle Highest Grade Completed)

    Name of School: ____________________________ Location: ___________________________________________

    Did you graduate?

     College/University 1 2 3 4 (Circle Highest Grade Completed)

    Name of College/University: _________________________ Location: _____________________________________

    Form 4101


Dates attended: From ___/___/___ to ___/___/___ Degree/Course of Study: _________________________ Graduate School or Vocational/Technical/Business Training:

    Name of School: ___________________________ Location: ___________________________________________ Dates attended: From ___/___/___ to ___/___/___ Course of Study: _____________________________________ Did you graduate?

     Have you ever been convicted of a felony? (Conviction is not an automatic bar to consideration for employment. You are not obligated to disclose sealed or expunged records of conviction or arrest)

    Are you currently serving probation or deferred adjudication for any crime?

    If you answered, "Yes" to any of the above, please explain:



    (Attach additional sheet, if necessary.)

     List all employment in the past ten years, most recent job first; include military service.

    Name of Employer: _____________________________ Type of Business: ___________________________________ City, State: ____________________________________ Phone: _____________ Supervisor: ____________________ Position: ___________________ Duties: _____________________________________________________________ Employment Dates: From: ___/___/___ to: ___/___/___ Reason for Leaving: __________________________________ Beginning Salary: $_____________________________ Ending Salary: $_____________________________________ Name of Employer: _____________________________ Type of Business: ___________________________________ City, State: ____________________________________ Phone: _____________ Supervisor: ____________________ Position: ___________________ Duties: _____________________________________________________________ Employment Dates: From: ___/___/___ to: ___/___/___ Reason for Leaving: __________________________________ Beginning Salary: $_____________________________ Ending Salary: $_____________________________________

    Name of Employer: _____________________________ Type of Business: ___________________________________ City, State: ____________________________________ Phone: _____________ Supervisor: ____________________ Position: ___________________ Duties: _____________________________________________________________ Employment Dates: From: ___/___/___ to: ___/___/___ Reason for Leaving: __________________________________ Beginning Salary: $_____________________________ Ending Salary: $_____________________________________

Within the past ten years, have you been terminated or asked to resign by an employer?

    If you answered, "Yes," please provide employer, dates and circumstances: _______________________________________ ____________________________________________________________________________________________________

    Clear Channel contacts prior employers to obtain references regarding work history, conduct and suitability for employment. May

    we contact your present employer at this time?

    Form 4101


I verify that all of the information on this application and attachments is true, correct and complete. I have not withheld any

    information requested by Clear Channel. I understand that false, misleading, incomplete or omitted information will result in rejection of my application, reprimand or termination from employment, whenever discovered.

    I authorize Clear Channel and its agents to confirm all information provided on this application and attachments (including resumes) and to investigate my suitability for employment. I agree to furnish additional information if requested. I release Clear

    Channel and all persons and companies from any claims, liabilities or damages from obtaining or furnishing information about me.

    This application is not a job offer or employment contract with Clear Channel for any specific time period. If hired, my employment will be for an indefinite time period and I may resign or be terminated by Clear Channel at any time without notice or

    requirement of cause.

I further understand and agree that no employee or official of Clear Channel has any authority to alter the terms of my at-will

    employment through oral statements or promises. In order to be binding on Clear Channel, any agreement or promise that alters this policy must be in writing and signed by the head of your division.

    Any conditional offer of employment by Clear Channel is subject to successful completion of all employment requirements including but not limited to verifying employment and personal references.

If employed, I agree to abide by and comply with all of Clear Channel's policies, rules and procedures, including Clear Channel

    Open Door Policy; Unlawful Harassment Policy; Policy on Sexual Harassment; Conflicts of Interest Policy; Electronic Communication and Internet Usage Policy; Threat, Violence and Weapons Policy; Safety Policy; Substance Abuse and Drug Testing Policy and the Arbitration Agreement.

_______________________ ________________________________________________

    Date Applicant's Signature

    Form 4101


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