Step 1 of 5 20% Application for Employment If you would like to be considered for employment, please fill out the application below. We will be in touch once we have your completed application on file.Full Name(Required) First Middle Last Email(Required) Primary Phone Number(Required)Available Start Date(Required) MM slash DD slash YYYY Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please Attach Your Cover Letter Here:Max. file size: 256 MB.Please Attach Your Resume Here:Max. file size: 256 MB. Employment History Please provide information on your most recent employer. If you have no employment history, simply enter “not applicable”.Title Company Name City, State Start Date of Employment (month and year) Last Date of Employment (month and year) Reason for leaving May we contact this employer? Yes No Second Most Recent Employer (NOTE: If you do not have any other employers to list, you may skip this page.)Title Company Name City, State Start Date of Employment (month and year) Last Date of Employment (month and year) Reason for leaving May we contact this employer? Yes No Next Most Recent Employer: (NOTE: If you do not have any other employers to list, you may skip this page.)Title Company Name City, State Start Date of Employment (month and year) Last Date of Employment (month and year) Reason for leaving May we contact this employer? Yes No Candidate Screening Please answer the following screening information:Are you looking for Full or Part-time employment?(Required) Full-TIme Part-Time Are you 18 years of age or older?(Required) YES NO Have you ever been employed at TLCA, either as a permanent employee or on a temporary basis through a staffing agency?(Required) YES NO If you are not a US citizen, does your visa or immigration status permit lawful employment?(Required) YES NO Please list the highest level of education that you have completed and/or any military experience.(Required) Please select your referral source Facebook Job-Ad Instagram Job-Ad Online Ad TLCA Website Indeed Current Employee Referral If Current Employee Referral : Please Spell Out Full Name & position Sign and DateIMPORTANT:PLEASE READ THE FOLLOWING AND SIGN/DATE It is understood and agreed upon that any misrepresentation by me in the application or subsequent interview process will be sufficient cause for cancellation of this application and/or separation from the employer’s services if I have been employed. Furthermore, the electronic signature below authorizes the employer to conduct background checks related to any arrests or convictions that are a matter of public record. I give the employer the right to investigate all references and to secure additional job related information about me. I hereby release from any liability the employer and its representatives to seek such information and all other persons, corporations or organizations for furnishing such information. TLC & Associates is an Equal Opportunity Employer, and as such does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on any basis prohibited by local, state, or federal law. By indicating “yes” below, I acknowledge that I accept and agree to the terms of the employment statement above.I accept and agree to the terms of the employment statement above:YESNOFull Name (Note: this will serve as your electronic signature)(Required) Please date your application. (Note: application date must be entered to be considered valid.)(Required) MM slash DD slash YYYY Date Δ
