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Employment Application

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Employment Application Personal Information

Please correct your First Name.

Please correct your Last Name.

Please correct your Last 4 Digits SSN.

Please correct your Present Address.

Please correct your City.

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Please correct your Zip Code.

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18 or older*

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Lawfully permitted to work in US*

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Other names used

Application Information

Type of Employment*

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Please correct your Position(s) Applied For.

Please correct your Rate of Pay Expected.

Days and Hours Available

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Please correct your Start Date.

Please correct your Method of Transportation.

Valid Drivers License*

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Employment Information

Employed Now*

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Current Employer

Current Job Duties

Applied to Clarion Before*

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Why Change Jobs?*

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Contact Current Employer

On Layoff or Subject to Recall*

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Worked for Clarion Before*

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Reason for Leaving Clarion Before

Able to Perform Duties of Job Applied For*

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Ever Been Bonded*

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Bonded on What Jobs

Ever Been Discharged*

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Discharge Explanation

Ever Been Convicted*

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Conviction Details

Ever Served in Military*

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Reference Number 1*

Please correct Reference 1 first name

Please correct Reference 1 last name

Please correct your Reference 1 relationship description.

Reference Number 2

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Education Information

Last Year Completed-
Elementary School*

Please correct your Last Year Completed - Elementary School.

Last Year completed - High

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Last Year Completed -

Post College?

Returning to College

Driving Record

Licenses Possessed

Points/Convictions in Last 5 Years

Employment History

Employers Excluded from Contacting and Reasons

Most Recent Employer

Please correct your Employer 1 Name.

Please correct your Address.

Please correct your Phone Number.

Please correct your Immediate Supervisor.

Please correct your Date of Hire.

Please correct your Date Left.

Please correct your Starting Pay.

Please correct your Ending Pay.

Title and Duties*

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Reason for Leaving*

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Second Most Recent Employer

Title and Duties

Reason for Leaving

Third Most Recent Employer


Title and Duties

Reason for Leaving

Applicant's Agreement and Certification

Applicant Certification of Honesty*

I hereby authorize the Comapny to conduct an investigation concerning all statements contained in my application for employment, to interview all employers and to conduct any other investigation that it deems appropriate. I further authorize past employers, all references and any other persons to answer all questions asked by the Company concerning my ability, character, reputation and previous employment record. I release all such persons from any liability or damages on account of having furnished such information. I request any duly constituted law enforcement agency or judicial officer to furnish the Company with all information pertaining to me concerning unexpunged convictions and I hereby release the Company and any law enforcement agency judicial or other individual from any liability arising from disclosure of such information pertaining to me which is obtained during said investigation. I agree, if employed, to comply with all lawful instructions of my supervisors and to abide by all present and subsequently issued rules and personnel policies of the Company. I further agree that (1) 1 will work faithfully and diligently, (2) be careful and avoid accidents, (3) come to work on time and (4) not be absent for any reason without three hours prior notice to my supervisor. I understand and agree that my employment is for no definite period and may be terminated at any time without cause and without any previous notice. I understand and agree that upon termination of employment, the Company may answer truthfully all questions asked by any prospective employer concerning my ability, character, reputation and employment record and I release the Company, its agents and employees from any liability or damages on account of having furnished such information.

Please correct your I certify that the information given by me in this application is true and complete in all respects and I agree that if employed and it is found to be false or incomplete in any way, I may be subject to dismissal without notice, if and when discovered..

Applicant Acknowledgement of Polygraph Regulation*

Please correct your That under Maryland Law, an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued e.

Please correct your Digital Signature

Map Location in Ocean City


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