PURE Media Group, Inc Employment Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name: *FirstLastAddress (including City, State, & Zip Code): *Phone #: *Email: *Position You Are Applying For: *Desired Salary: *Date Available: *Are You Legally Authorized To Work In The U.S.?: *— Select Choice —YESNOWill You Now Or In The Future Require Sponsorship: *— Select Choice —YESNODriver Information: *Provide Driver License #, State, Exp DateEmployment History: *Employer #1Position:Dates Employed: *Reasons For Leaving: *Major Responsibilities: *Key Accomplishments: *May We Contact This Employer: *YESNO(If Yes, Please Provide Contact Information):Name, Email, Phone #Employment History: *Employer #2Position: *Dates Employed: *Supervisor: *Reason For Leaving: *Major Responsibilities: *Key Accomplishments: *May We Contact This Employer: *YESNO(If Yes, Please Provide Contact Information):Name, Email, Phone #Employment History: *Employer #3Position: *Dates Employed: *Supervisor: *Reason For Leaving: *Major Responsibilities: *Key Accomplishments: *May We Contact This Employer: *YESNO(If Yes, Please Provide Contact Information):Name, Email, Phone #High School Attended: *Include Year Of GraduationCollege Attended:Include Year Of Graduation. If You Did Not Attend, Just Enter “None”Degree Obtained:Other Trainings/Certifications:Name Of Reference #1: *Reference's Company: *Reference's Phone #: *Relationship To Reference: * #1: You Obtained: Name Of Reference #2: *Reference's Company: *Reference's Phone #: *Relationship To Reference: *Name Of Reference #3: *Reference's Company: *Reference's Phone #: *Relationship To Reference: *Background Check Authorization: *YESNOI authorize PURE Media Group, Inc. to verify the information provided in this application, contact employers and references, and obtain a background report consistent with applicable law. I understand a separate Fair Credit Reporting Act disclosure may be provided if a consumer report is obtained.Motor Vehicle Record Authorization: *YESNOI authorize PURE Media Group, Inc. to obtain my motor vehicle record for employment purposes if driving is a job requirement.Confidentiality Acknowledgment: *YESNOI understand that client lists, pricing, marketing strategies, financial information, and other confidential business information belong to PURE Media Group and must not be disclosed.Employment At-Will Acknowledgment: *YESNOIf hired, I understand my employment is at will unless otherwise provided in a written agreement signed by an authorized representative.Submit
