Nebraska's #1 Voted Computer Repair Company

Application

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Personal Information

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Are you 18 or Older?* YesNo

Desired Employment

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Which location(s) would you like to be considered for? LincolnOmahaPapillion
Are you Employed Now? YesNo
If so, may we inquire of your current employer? YesNo
Have you applied to Schrock Before? YesNo
If so, where? LincolnOmahaPapillion
Have you worked for Schrock before? YesNo
If so, where? LincolnOmahaPapillion
Who referred you to Schrock?
Employment AgencyNewspaper AdvertisingFriendInternet AdState Employment OfficeCollege Placement ServiceWalk-inOther

Education

School Level Name / Location of School # of years atteneded Did you graduate? Subjects Studied
Middle School
High School
College
Trade School
Other

General Information

Former Employers

Please list former employers starting with the most recent

Employer One

Employer Two

Employer Three

Employer Four

Employer Five

References

Name E-mail / Phone Business / Relationship Years Acquainted

Service Record

Branch of Service:

Date of discharge:

Have you ever been convicted of a felony? YesNo
If yes, explain. (will not necessarily exclude you
from consideration):

Authorization

"I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FASIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.
I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE 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, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE."

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