Digital Marketing Employment Application

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Employer Primary Contact

Applicant Information

Your Name*

First Last

Your Phone*

Alternate Phone

Your Email Address*

Enter Email Confirm Email

Your Home Address*

Street Address Unit / Suite Number City State Zip Code

How were you referred to us?

When is the best time for us to reach you via telephone? (Select all that apply)*

Mornings
Early Afternoon
Afternoon
Late Afternoon
Early Evening
Anytime

Position You're Applying For

Position

Hours You Are Available for Work*

Please tell us what time frames you are available to work each day of the week (i.e. 6am-3pm, Anytime, etc…)

Are you applying for:*

Temporary work – such as summer or holiday work?
Regular part-time work? (less than 32 hours per week)
Regular full-time work? (32 hours or more per week)

Mark all that apply

Can you work on the weekends?*

Yes
No

Can you work evenings?*

Yes
No

Are you available to work overtime?*

Yes
No

Personal Information

Have you ever applied to / worked for us before?*

Yes
No

If yes, please explain (include date):

Do you have any friends, relatives, or acquaintances working for Elixir Web Marketing?*

Yes
No

If yes, state name & relationship:

If hired, would you have reliable transportation to/from work?*

Yes
No

Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age.)*

Yes
No

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?*

Yes
No

If hired, are you willing to submit to and pass a background check and controlled substance test?*

Yes
No

Are you able to perform the essential functions of the job for which you are applying, either with / without reasonable accommodation?*

Yes
No

If no, list accommodations necessary

(Note: Johnsons Home & Garden complies with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.)

Have you ever been convicted of a criminal offense (felony or misdemeanor)?*

Yes
No

If yes, please describe the crime – state nature of the crime(s), when and where convicted and disposition of the case.

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Education, Training and Experience

High School

School Name

School Address

School city, state, zip

Number of years completed

Did you graduate?

Yes
No

College / University

School Name

School Address

School city, state, zip

Number of years completed

Did you graduate?

Yes
No

Degree or Diploma Earned

Vocational School

School Name

School Address

School city, state, zip

Number of years completed

Did you graduate?

Yes
No

Degree or Diploma Earned

Military Service

Branch

Rank in military

Total years of service

Skills / Duties

Related details

Additional Information

Do you speak, write or understand any foreign languages?

Yes
No

If yes, describe which languages(s) and how fluent of a speaker you consider yourself to be.

Do you have any other experience, training, qualifications, or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us?

Yes
No

If yes, please explain:

Previous Employment

Are you currently employed?

Yes
No

If you are currently employed, may we contact your current employer?

Yes
No

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Number of Employers (NOT visible)

This will set the number of rows to show in "Your Previous Employers" section.

Your Previous Employers*

Please list your previous three employers’ information below.

Employer	Dates of employment	Position(s)	Supervisor	Supervisor’s contact number

More About You

List achievements or other special skills that relate to the position for which you are applying*

Upload Your Resume

Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

upload your resume in .pdf, .doc or .docx format

Terms and Conditions of Employment

Terms and Conditions

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by Elixir Web Marketing, terms for my immediate expulsion from Elixir Web Marketing.

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or Elixir Web Marketing.

I authorize Elixir Web Marketing to examine and solicit information regarding my character, general reputation, credit, previous employment and similar background information and to contact all of my references. I hereby authorize and release all parties and persons connected with any such request for information from all claims, liabilities and damages for any reason arising out of the furnishing of such information. If employed I release Elixir Web Marketing from any liability for future references it may provide regarding my work history at Elixir Web Marketing. I understand that an investigative consumer report may be obtained through personal interviews with my neighbors, friends or associates. If I am refused employment on the basis of such report I have a right, upon written request from me within a reasonable time, to complete and accurate disclosure of the nature and scope of the investigations requested by Elixir Web Marketing. I release Elixir Web Marketing, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

Initials*

Initials for your full name.

Applicant Signature (Typed name as your signature)*

Acceptance*

I agree to the Terms and Conditions

Phone

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