Have a question? We're here to help you: Lynchburg: (434) 455-6500 | Roanoke: (540)-776-3622

Application for Employment Form

Notice to Applicants

 

If you require an accommodation because of a physical or mental disability in order to participate in any phase of the application process, please make that fact known to the individual processing your application.

If you are required to take any pre-­‐employment screening tests, and you require an accommodation because of a physical or mental disability to enable you to take or successfully complete such a test, please make that fact known in advance to the test administrator.

If an offer of employment is made and, because of a physical or mental disability, you will need an accommodation to perform any essential job functions, please make that fact known to the individual processing your application.

 

Job Application

Job Application

PERSONAL INFORMATION

DESIRED EMPLOYMENT

On-Call Scheduling Coordinator

SERVICE RECORD

EMPLOYMENT HISTORY

Most Recent Employer

Previous Employer

Click to Add More Previous Employers

Previous Employer

Previous Employer

PERSONAL REFERNCES

Please give the names of three persons to whom you are not related, whom you have known at least three years. Do not duplicate business references.

References 1

References 2

References 3

LICENSURE

Please list any license, certification, or registration earned relevant to the position for which you are applying.
License/Certification/Registration One
License/Certification/Registration Two

DISCLOSURE STATEMENT

CONDITIONS OF EMPLOYMENT

If hired, your offer of employment is contingent upon a satisfactory drug test result and criminal background check. Proof of your identity and employment eligibility in the United States must be established by appropriate documentation at the time you begin work.

Generation Solutions, Inc. is an equal opportunity employer and does not discriminate against applicants or employees on the basis of sex, race, color, religion, national origin, disability, citizenship, ancestry, age, marital status, genetic information, physical or mental disability, or past, present, of future service in the Uniformed Services of the U.S., or any other legally protected status. Generation Solutions operates under an Employment at Will Policy. Employment by Generation Solutions does not confer any contractual right, either expressed or implied, to remain in Generation Solutions’ employ; nor does it guarantee any fixed terms and conditions of employment. Employment is not for any specific time and may be terminated at will, with or without cause, and without prior notice

AVAILABILITY

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, falsified 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 Generation Solutions from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of Generation Solutions 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 signed by an authorized company representative.

I agree not to provide private services to any client of the Generation Solutions office for which I am employed, either during my employment with Generation Solutions or for a period of one year after my termination of employment with Generation Solutions. I understand that engaging in such activity will result in my being disqualified for rehire with Generation Solutions. Such activity will also result in a monetary penalty assessed the client.