213 Virginia Street, Urbanna, Virginia
(804) 758-8000
sarah@somediff.com

Something Different Employment Application

Personal Information

All fields in the personal information section must be filled out.

Name:

Address:

City:

State:

Zip:

Email:

Cell Phone:

Position Desired:

Salary Desired:

Date Available to Start:

Date of Birth:

Education Certificate:

Have you worked at Something Different before?

Yes No

Have you applied at Something Different before?

Yes No

Past Employment Experience ~ One

Business Name:

Address:

City:

State:

Zip:

Phone:

Job Title:

Salary:

Reasons for leaving:

May I contact?

Supervisor:

Past Employment Experience ~ Two

Business Name:

Address:

City:

State:

Zip:

Phone:

Job Title:

Salary:

Reasons for leaving:

May I contact?

Supervisor:

Past Employment Experience ~ Three

Business Name:

Address:

City:

State:

Zip:

Phone:

Job Title:

Salary:

Reasons for leaving:

May I contact?

Supervisor:

By clicking the submit button below, I certify that all the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations. and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice. at any time. at either my or the company’s option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.