Applicant Date of Application 9/5/2010
All Information Must Be Provided Otherwise Your Application Will Not Be Considered.
First Name
Last Name
Home Phone Alternate Phone
         
Address
City State Zip Code
Email
           
Position
What Position(s) Are You Applying For?
(check all that apply)
Availability
Date Available To Start
Are you able to work overtime if needed? Pay Expectations $ per
Are you available to work an overnight shift? Total Available Hours per
How were you referred to us?
Disclosure
Are you a previous employee of IBT? If yes, provide dates  to 
Are you authorized to be legally employed in the United States?
Are you over 18 years of age?
Have you ever been convicted of, plead guilty, or no contest to a crime?
If yes, provide details (a criminal conviction will not necessarily be a bar to employment)
Employment History
This Section Must Be Completed Even If A Resume Is Attached.
List employment history starting with your most recent position held. The Company reserves the right to contact previous employers to verify information.
Employer (1)
Employer
Address
Phone JobTitle
Work Performed
Reason For Leaving
Supervisor
Starting Date
Ending Date
Starting Pay  per 
Ending Pay  per 
May we contact for reference?
Employer (2)
Employer
Address
Phone JobTitle
Work Performed
Reason For Leaving
Supervisor
Starting Date
Ending Date
Starting Pay  per 
Ending Pay  per 
May we contact for reference?
Employer (3)
Employer
Address
Phone JobTitle
Work Performed
Reason For Leaving
Supervisor
Starting Date
Ending Date
Starting Pay  per 
Ending Pay  per 
May we contact for reference?
Professional References
Name Relationship Phone Number Years Known
Reference (1)
Reference (2)
Reference (3)
Education
(High School, GED, College, Trade School, Other)
Name of Institution Location Course of Study Years Completed Graduated
Institution (1)
Institution (2)
Institution (3)
Statement
Please Read The Following Statement Carefully and Sign Below
In consideration of my emplyment, if I am employed, I agree to conform to the employment policies, practices, and procedures of Integrated Book Technology, Inc. and I understand that my employment and compensation can be terminated, with or without notice, at any time, at the option of either the Company or myself. I understand that no representative of the Company, other than the President and the Owners, has the authority to enter into any agreement for any specified period of time or to make any agreement to the foregoing or to make any verbal promises, commitments, or statements of any kind regarding the Company's policies, procedures, or any other issues that are legally binding by the Company. I understand that completion of this application for employment does not guarantee that I have been employed by this Company. I hereby affirm that my answers to these statements are true and correct to the best of my knowledge. I have not knowingly withheld any fact or circumstance that would, if disclosed, affect my application unfavorably. I understand that any misrepresentation, deception, or false statement made in this employment application may result in me not being considered for employment, and if not discovered by the Company until after my becoming employed, is grounds for, and may result in, my immediate termination.
Today's Date 9/5/2010