Employment Application

We are an Equal-Opportunity Employer.

If you would like to download a PDF (printable version of our employment application, please click here. Upon completion, fax to: 570.473.8432 or email to: nreedy@nshr.com

 
Applicant Information
Name *
Name
Date
Date
Address
Address
Phone *
Phone
Date Available
Date Available
$
Are you a citizen of the United States? *
If no, are you authorized to work in the U.S.?
Have you ever worked for this company? *
Have you ever been convicted of a felony? *
Education
Address
Address
Did you Graduate *
Address
Address
Did you graduate?
Address
Address
Did you graduate?
Reference #1
Name *
Name
Phone *
Phone
Address
Address
Reference #2
Name *
Name
Phone *
Phone
Address
Address
Reference #3
Name *
Name
Phone *
Phone
Address
Address
Previous Employment #1
Address
Address
Supervisor
Supervisor
Supervisor Phone
Supervisor Phone
May we contact your previous supervisor for a reference?
Previous Employment #2
Address
Address
Supervisor
Supervisor
Supervisor Phone
Supervisor Phone
May we contact your previous supervisor for a reference?
Previous Employment #3
Address
Address
Supervisor
Supervisor
Supervisor Phone
Supervisor Phone
May we contact your previous supervisor for a reference?
Military Service
Disclaimer
Verification *
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.