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Untitled Document
ABBA Essilor

Application
For Employment


We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, disability, the presence of a non-job related medical condition, or any other legally protected status.


Application Date:
Name  
Last
First
Middle
   
Address  
Street
City
State
Zip
   
Telephone
   
Position Applied For
   
Referral Source
Employee Relative Internet Posting
Employment Agency Newspaper Other
If Reffered by an employee, name of employee
   
Have you filed an application with Essilor before? Yes No
Have you ever been employed with Essilor before? Yes No

Are you legally authorized to work for any employer in the United States?
(proof of citizenship or immigration status will be required upon employment)

 Yes No
Have you been convicted of a felony within the last 7 years? Yes No
If so please provide dates and details.
(Responding yes above is not an immediate disqualification of employment)
   
   
Salary Requirements
Date Available
Are you applying for Full-Time Part-Time Shift Work Temporary
Are you willing to work irregular hours and overtime as required? Yes No
What days are you available to work?:
What hours are you available to work?:

Employment History

Present or Last Employer      
Company Name Address
Employment Dates (from - to) Starting Salary Leaving Salary
Job Title Job Duties
Reason For Leaving
   
Previous Employer      
Company Name Address
Employment Dates (from - to) Starting Salary Leaving Salary
Job Title Job Duties
Reason For Leaving
   
Previous Employer      
Company Name Address
Employment Dates (from - to) Starting Salary Leaving Salary
Job Title Job Duties
Reason For Leaving
   
Previous Employer      
Company Name Address
Employment Dates (from - to) Starting Salary Leaving Salary
Job Title Job Duties
Reason For Leaving
   

 

Education
Name Address (street, city, state) Major course of study Last Year Completed (1-4) Degree & Year Awarded
High School or Prep
Business School
College
Graduate Work
Special Skills and Qualifications:
    
 

Professional References

      
Name Company Title Phone Number
       
       
 
The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application may result in my dismissal. I further understand that this application is not and is not intended to be a contract for employment, nor does this application obligate the employer in any way if the employer decides to employ me. I understand and agree that my employment is at-will and can be terminated by either party with or without notice, at any time, for any reason, or no reason. No one other than an officer of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing and then only in writing signed by an officer.

I hereby authorize and permit credit companies, police agencies, former employers, and schools to provide information concerning me to Essilor of America, or any of its subsidiary or affiliated corporations, and I expressly release Essilor of America and any such information provider from any liability related to the provision of information pertaining to me.

You must agree to the terms before submitting I understand that by submitting this form, I agree to the above conditions

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