DataLocker Employment Application

Applicant Information

Name*

First Last

Email*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website / Portfolio

Are you authorized to work in the United States?*

Yes
No

Have you ever worked for DataLocker?*

Yes
No

When?*

Have you ever been convicted of a felony?*

Yes
No

Please explain:

Education

Highest Level of Education*

High School*

College*

Address

Did you graduate?*

Yes
No

Degree/Area of Study

Previous Employment

Company*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

Job Title*

Starting Salary

Ending Salary*

Responsibilites

Start Date*

End Date*

Reason for Leaving*

May we contact your previous supervisor for a reference?*

Yes
No

Do you have additional work experience?*

Yes
No

Company*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

Job Title*

Starting Salary

Ending Salary*

Responsibilites

Start Date*

End Date*

Reason for Leaving*

Do you have additional work experience?*

Yes
No

Company*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

Job Title*

Starting Salary

Ending Salary*

Responsibilites

Start Date*

End Date*

Reason for Leaving*

May we contact your previous supervisor for a reference?*

Yes
No

Military Service

Do you have military service experience?*

Yes
No

Branch

From

To

Rank at Discharge

References

Please list three professional references.

Name*

First Last

Relationship*

Company*

Phone*

Name*

First Last

Relationship*

Company*

Phone*

Name*

First Last

Relationship*

Company*

Phone*

Disclaimer

Disclaimer*

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.

Background Check

Disclosure of Intent to Obtain a Background Check, Consumer Report or Investigative Consumer Reports*

DataLocker may obtain background checks, consumer reports, or investigative consumer reports, in connection with your employment application during the next 90 days or, if hired, at any time during your employment in accordance with applicable law. Reports include record checks conducted by consumer reporting agencies and may include driving records, criminal records, education and employment verification, verification of professional licenses and/or certifications, and information from references, etc. Investigative consumer reports include investigations conducted by consumer reporting agencies through personal interviews (or through any means in California) on information as to character, general reputation, personal characteristics, or mode of living. You may make a written request for a disclosure of the nature and scope of any investigative consumer report. Investigative reports include record checks and also may contain information culled from interviews with former employers, business references, and/or personal references. You can access a separate document entitled a "Summary of Your Rights under the Fair Credit Reporting Act" at insperity.com/summary-of-rights-FCRA. You can also make a written request for a summary of your consumer rights.

By checking this box, I acknowledge that DataLocker may obtain a background check, consumer report and/or investigative consumer report.

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