APPLICATION FOR EMPLOYMENT

We consider applicants for all positions without regard to race, color, religion, sex, national origin,
age, marital or veteran status, disability, or any other legally protected status.

If you would like to send your resume in addition to this application,
please click here and forward your resume through email.

Complete all information and electronically sign. Incomplete applications may not be considered.

Date:

Job applied for:

Name:

Street Address:

City, State, Zip:

Phone(daytime):

Phone(home):

Email address:

Social Security Number:

Are you able to work:

Which locations would you prefer to be considered for employment:

First Choice
Second Choice

Number of hours per week

Please select shift and days available:

Any
1st Shift
2nd Shift

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

When are you typically available for an interview (times and days):

Can you work weekends:

On what date would you be available for work:

Are you 18 years of age or older:

Do you have the legal right to work in the USA:

Have you ever been convicted of a crime:

If yes, list all convictions:

Other skills/qualifications for this job (special training):

If referred by current associate, please list Assoicate's Name:

Tell us where you heard about NGW and this position:

EDUCATION/TRAINING

	High School	College/University	Other
School Name
City, State
Year Completed Degree
Received Diploma
Degree/Diploma Obtained

EMPLOYEEMENT EXPERIENCE

Start with your present or most recent job

1.Employer

Company Name:
Address:
Phone:
Job Title:
Supervisor:
Dates Employed:	From To
Wages:	Start End
Work Performed:
Reason For Leaving:

2.Employer

Company Name:
Address:
Phone:
Job Title:
Supervisor:
Dates Employed:	From To
Wages:	Start End
Work Performed:
Reason For Leaving:

3.Employer

Company Name:
Address:
Phone:
Job Title:
Supervisor:
Dates Employed:	From To
Wages:	Start End
Work Performed:
Reason For Leaving:

Please read before signing:

I certify that the information contained in this application is true, complete and correct to the best of my knowledge. I understand that any omission of facts or misrepresentation is cause for denial of employment and/or dismissal from employment. I authorize investigation of my background and all statements made on this application or in any pre-employment interview, including, but not limited to my employment record, personal references, school record and police record, if any.

I understand that this application for employment shall be considered active for a period of time not to exceed 12 months from the time it is received or reviewed. If I wish to be considered for employment beyond this time period, I understand that I will need to reapply at that time.

I understand that neither this document nor any offer of employment from Next Generation Wireless or its affiliates constitutes an employment contract unless a specific document is executed in writing by the Senior Executive of the applicable organization.

I understand that just as I am free to resign at any time if I am employed by Next Generation Wireless or its affiliates, the employer reserves the right to end my employment at any time with or without notice or cause (unless specifically excluded by another employment agreement.

Applicant's Signature Date