GRANT & WEBER

A Professional Collection Agency
26575 W. Agoura Road
Calabasas, CA 91302
(818) 878-7700

Grant & Weber is an equal opportunity employer. Applicants are considered for all positions without regard to race, color, religion, gender, sexual orientation, national origin, age, disibility, pregnancy, marital status, military service, or any other legally protected class.

Today's Date:
Position Applied For:
*(Optional) SS#:
Your Email

Full Name of Applicant:
Street Address:
City:
State:
Zip:
Home Phone:
Mobile Phone:

Have you ever filed an application at GRANT & WEBER before?
Yes No

If yes, when?

Can you travel if the position requires it? Yes No

Are you currently employed? Yes No

Are you authorized to work in the United States? Yes No
(Proof of citizenship or immigration will be required upon employment.)

Have you been convicted of a felony within the last seven (7) years?
Yes No
If answer is yes, please explain:

Are you a Veteran of the United States Military Service?
Yes No
If answer is yes, please explain:

In case of emergency, contact:

Phone Number:

Were you referred to Grant & Weber by anyone? Yes No

If yes, who?:

If no, how did you hear about this position?:

Available to start work on:

You are available to work:

Full Time

Part Time

Short Term

Days Available:

Hours Available:

Please list your salary requirements:

Hourly:	(Or)
Annually:

EDUCATION:

HIGH SCHOOL: (select highest grade completed):
8 9 10 11 12

Did you receive a high school diploma? Yes No

Under Graduate/College/University/Trade School:

Name:
City:
State:
Zip:
Major:
Degree/Graduate:

Name:
City:
State:
Zip:
Major:
Degree/Graduate:

PERSONAL REFERENCES:

List three (3) persons as references who are NOT related to you and who are NOT your previous employers:

Name:
Telephone:
Address:

Name:
Telephone:
Address:

Name:
Telephone:
Address:

Please indicate any language(s) you know, other than English:

Speak:
Read and/or Write:

Summarize any special job-related skills and qualifications
gained from any previous employment or experience:

Please list licenses and/or certifications pertinent to the posotion(s)
for which you are applying:

Please liat any Honors and/or Awards received:

Please list any professional, trade, business or civic activities/offices held:

Business:		Position/Title:
Business:		Position/Title:

EMPLOYMENT EXPERIENCES:

Please start with your present or most recent job.
Include Military Service assignments & volunteer activities

Employer:
Telephone:
Address:
City:
State:
Zip:
Job Title:
Responsibilities:
Start Date:
End Date:
Reason for Leaving:

Employer:
Telephone:
Address:
City:
State:
Zip:
Job Title:
Responsibilities:
Start Date:
End Date:
Reason for Leaving:

Employer:
Telephone:
Address:
City:
State:
Zip:
Job Title:
Responsibilities:
Start Date:
End Date:
Reason for Leaving:

Please paste a copy of your resume here or enter the url address to your resume if posted online.

I CERTIFY THAT THE ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION FOR EMPLOYMENT AS MAY BE NECESSARY IN ARRIVING AT AN EMPLOYMENT DECISION. I UNDERSTAND THAT THIS APPLICATION IS NOT AND IS NOT INTENDED TO BE A CONTRACT OF EMPLOYMENT.

IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW(S) MAY RESULT IN IMMEDIATE DISCHARGE.

I ALSO UNDERSTAND THAT I AM REQUIRED TO ABIDE BY ALL THE RULES AND REGULATIONS OF THE COMPANY.

IN ADDITION, I UNDERSTAND THAT GRANT & WEBER IS AN AT-WILL EMPLOYER AND IF I AM EMPLOYED BY GRANT & WEBER, MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE, AT THE SOLE DISCRETION AND OPTION OF THE COMPANY.

Click Submit only if you agree to the terms of the Applicant's Statement