Empereon Marketing is always looking for the right people to add to our team of Marketing Professionals.
For employment inquiries see
contact information
or fill out and submit the on-line form below (please fill out all applicable fields).
Empereon On-Line Employment Application
This is an e-mail form - you must have an active e-mail account on your computer to submit this form.
Personal Information:
Last Name:
First Name:
Middle Name:
Social Security Number:
Present/Permanent Address:
Street:
Apt. No:
City:
State:
Zip:
Are You 16 Years or Older?
Yes
No
Daytime Phone:
Desired Employment:
Position:
Date You Can Start:
Are You Looking For:
full-time
part-time
full-time, but will accept part-time
Are You Employed Now?
Yes
No
If so, may we inquire of your present employer?
Yes
No
Have you ever applied to Empereon Marketing before?
Yes
No If Yes, When:
Have you ever worked for Empereon Marketing before?
Yes
No If Yes, When:
If so, reason for leaving Empereon:
Name of last supervisor at Empereon:
Who referred you to this company?
Employment Agency
Newspaper Advertising
State Employment Office
Internet
College Placement Service
Friend:
Other:
Do you have any friends or relatives currently working for Empereon Marketing?
Yes:
No
Please list any skills (computer, sales etc.) or qualifications you feel
would be relative to the position you are applying for:
Education:
School Level
Name and Location of School
Yrs. Attended
Graduate?
Degree
High School
Trade, Business, or Correspondence School
College
General:
Subjects of special study of research work
Special Training
Special Skills
Former Employers:
List below your last three employers, starting with your most recent employer first
Name & Address of present or last employer:
Name:
Street:
Suite:
City:
State:
Zip:
Starting Date:
Leaving Date:
Weekly Starting Salary:
Weekly Ending Salary:
May we contact your supervisor?
Yes
No
Name of supervisor:
Title:
Phone No. with ext.:
Description of work:
Reason for leaving:
Name & Address of previous employer:
Name:
Street:
Suite:
City:
State:
Zip:
Starting Date:
Leaving Date:
Weekly Starting Salary:
Weekly Ending Salary:
May we contact your supervisor?
Yes
No
Name of supervisor:
Title:
Phone No. with ext.:
Description of work:
Reason for leaving:
Name & Address of previous employer:
Name:
Street:
Suite:
City:
State:
Zip:
Starting Date:
Leaving Date:
Weekly Starting Salary:
Weekly Ending Salary:
May we contact your supervisor?
Yes
No
Name of supervisor:
Title:
Phone No. with ext.:
Description of work:
Reason for leaving:
References:
Below, give the names of three persons to whom you are not related and that you have known for at least one year.
Name
Address
Business
Yrs. Acquainted
Service Record:
Branch of Service:
Rank:
Discharge date:
Have you ever been convicted of a felony?
Yes
No
If yes, explain (will not necessarily exclude you from consideration)
Authorization:
"By submitting this form - I certify that the facts contained in this application are true and complete to the best of my knowledge. Further, I understand that if employment is offered, falsified information or statements on this application shall be immediate grounds for dismissal.
I hereby authorize the investigation of any and all information contained herein including but not limited to, my references and previous employers. I further authorize all persons and organizations listed on this form to release any and all information pertinent to this employment request to Empereon Marketing. I agree to release all persons and organizations on this form from any and all liability for any damage that may result from the investigation or utilization of such information.
I also understand and agree that no representative of Empereon Marketing has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement to the contrary, unless otherwise noted and signed in writing by a managing partner of Empereon Marketing."
