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Employment Application
Job Application – Complete
Step
1
of
8
12%
YOUR INFORMATION
AN EQUAL OPPORTUNITY EMPLOYER: EMPLOYER DOES NOT DISCRIMINATE IN EMPLOYMENT BECAUSE OF RACE, COLOR, SEX, RELIGION, NATIONAL ORIGIN, AGE, DISABILITY, MARITAL STATUS, OR ELIGIBILITY FOR SERVICES IN THE ARMED FORCES OF THE UNITED STATES.
YOUR NAME
(Required)
First
Middle
Last
OTHER NAMES USED
EMAIL
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PHONE
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ADDRESS
(Required)
Street Address
Address Line 2
City
Alabama
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American Samoa
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Armed Forces Americas
Armed Forces Europe
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State
ZIP Code
POSITION DESIRED
(Required)
Salary/Wage Desired
Date Available
MM slash DD slash YYYY
USE THE NEXT AND PREVIOUS BUTTONS AT THE BOTTOM OF THE FORM TO NAVIGATE THE ONLINE APPLICATION.
BACKGROUND INFORMATION
WERE YOU REFERRED BY A CURRENT PIXAURA EMPLOYEE?
NO
YES
WHO WAS THE ICMC EMPLOYEE THAT REFERRED YOU
ARE YOU LEGALLY ALLOWED TO WORK IN THE UNITED STATES?
(Required)
YES
NO
If hired, Federal law requires documentation verifying your identity and legal authorization to work in the U.S. Employment is dependent upon proof of citizenship, employment authorization, or presentation of an alien registration number.
ARE YOU 16 YEARS OF AGE OR OLDER
(Required)
YES
NO
EDUCATIONAL BACKGROUND
HIGH SCHOOL EDUCATION COMPLETED OR GED PASSED
(Required)
YES
NO
EDUCATION: HIGHEST LEVEL GRADE COMPLETED
9TH – HIGH SCHOOL
10TH – HIGH SCHOOL
11TH – HIGH SCHOOL
12TH – HIGH SCHOOL
PROFESSIONAL DEGREE / BACKGROUND
1) COLLEGE/UNIVERSITY/TRADE SCHOOL
CITY/STATE
DEGREE/DIPLOMA
MAJOR
COMPLETED
YES
NO
2) COLLEGE/UNIVERSITY/TRADE SCHOOL
CITY/STATE
UNITS
DEGREE/DIPLOMA
MAJOR
COMPLETED
YES
NO
MILITARY BACKGROUND
US MILITARY SERVICE
YES
NO
MILITARY BRANCH
RANK
DATE OF SERVICE
WORK HISTORY
EMPLOYER – CURRENT / MOST RELEVANT
COMPANY NAME
(Required)
JOB TITLE
(Required)
Date Started
(Required)
Date Ended
(Required)
COMPANY ADDRESS
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
JOB DUTIES
(Required)
SUPERVISOR
REASON FOR LEAVING
MAY WE CONTACT
YES
NO
CONTACT NAME
Equal Employment Opportunity
This information is being requested in accordance with federal regulations. The information is VOLUNTARY and will not be used when considering you for employment with our company.
PLEASE LIST LANGUAGES SPOKEN FLUENTLY, OTHER THAN ENGLISH
Racial or Ethnic Group
American Indian/Alaskan
Hispanic/Latino
Asian/Pacific Islander
White/Caucasian
Black/African American
Other
Other
If you selected other please type your answer here.
Gender
Female
Male
Military Service
Pre-Vietnam Era
Post Vietnam Era
Vietnam Era
Disabled Veteran
How did you hear about the position
Select all that apply
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Company Employee
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Placement Office
Professional Publication
Website
Other
Other
If you selected other please type your answer here.
UPLOAD YOUR RESUME IF APPLICABLE
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Max. file size: 10 GB, Max. files: 3.
Consent
(Required)
IMPORTANT – READ BEFORE SIGNING
I certify that the information in this application is true and complete. Any false statements, concealments or omissions are grounds for refusal to hire or for immediate dismissal if hired.
I authorize Pixaura Digital Marketing llc to investigate and verify the information contained in this application which may include contacting my schools and former employers, and for Pixaura Digital Marketing llc to keep and preserve such records.
I understand that if hired, my employment is at will and may be terminated by either the Company or me, without cause and without notification.
THIS APPLICATION DOES NOT CONSTITUTE A CONTRACT FOR EMPLOYMENT, EXPRESSED OR IMPLIED.
If employed, I agree to adhere to the Company’s Rules and Regulations.
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