:: Paycheck Advance ::

Careers

Please choose the company you are applying to:

Personal information

First name*:

Last name*:

Middle name:

Social security number:

Home Address*:

City*:

State*:

Zip Code*:

Home Telephone*:

Cell Phone:

Date you can Start*:

Position Applying For:

Expected Salary:

Education

Last completed educational facility

School:

Major:

Years Completed:

Current Status*:

Graduated

Currently Enrolled

Not Currently Enrolled

Employment information

List the most recent, chronologically, without any omissions

Employer Name:

Contact Person:

Employer address:

Employer Phone:

Position Held:

Start Date:

Separation Date:

Starting Wage:

Wage @ time of separation:

Job Description:

Skills Learned at this Job:

Suggestions to make this job more efficient/enjoyable:

Reason for Separation:

Second Employer Name:

Contact Person:

Employer address:

Employer Phone:

Position Held:

Start Date:

Separation Date:

Starting Wage:

Wage @ time of separation:

Job Description:

Skills Learned at this Job:

Suggestions to make this job more efficient/enjoyable:

Reason for Separation:

Third Employer Name:

Contact Person:

Employer address:

Employer Phone:

Position Held:

Start Date:

Separation Date:

Starting Wage:

Wage @ time of separation:

Job Description:

Skills Learned at this Job:

Suggestions to make this job more efficient/enjoyable:

Reason for Separation:

Favorite Job you have had and reason it appealed to you

Reason you want to work here

Special skills you can offer this job

Please say a few words about your education and/or career goals

Please rate your priorities in order of importance 1 thru 8 (1 being your highest priority)

Starting Wage:

Opportunity for Advancement

Comfortable and fun working conditions

Full Time Employment

Benefits

Keeping Bu

Consistent and fair management

Hours (Shifts, weekends...)

Are you 18 or older (19 in Nebraska)?*

Yes

Are you a US Citizen?*

Yes

If no, do you have a legal right and necessary documents to work in the US?

Yes

Have you had any convictions?

Yes

If yes, please explain as we are licensed and bonded.

In Case of Emergency, please notify:

Name*:

Address*:

City*:

State*:

Zip Code*:

Phone*:

Another person, preferably not living with you:

Name:

Address:

City:

State:

Zip Code:

Phone:

Please read carefully and sign:

                                            In submitting this application for employment, I understand that an investigation may be made   whereby information is obtained regarding my character, previous employment, general reputation, educational background, credit record and/or criminal history. I authorize anyone possessing this information to furnish it to Paycheck Advance/Superior Wireless and/or a third party company upon request and I release anyone so authorized, Paycheck Advance/Superior Wireless and any third party company from all liability and damages whatsoever in furnishing, obtaining and using said information. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of Paycheck Advance/Superior Wireless. I understand and agree that if employed, the employment will be "at will". That is, either Paycheck Advance/Superior Wireless or I may end the employment relationship at any time, for any reason, or for no reason. I understand that receipt of this application by Paycheck Advance/Superior Wireless does not imply employment and that this application and/or any other Paycheck Advance/Superior Wireless documents are not contracts of employment.

Applicants Signature*:

Date*:

Please read carefully and sign:

As required by the Fair Credit Reporting Act, this is to advise you that, in connection with your application for employment with Paycheck Advance/Superior Wireless, a consumer report regarding your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living, may be obtained with respect to you for employment purposes from a consumer reporting agency.

I hereby authorize Paycheck Advance/Superior Wireless to obtain and use a consumer report with respect to me for employment purposes.

Dated*:

Applicants Signature*:

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