Employment Application

Attach Resume *

Maximum upload size: 33.55MB

Email Address

First Name *

Middle Name

Last Name *

Primary Phone Number *

Secondary Phone Number

Address *

How did you hear about us? How did you hear about us?

BSGI Employee Name

If referred by a BSGI Employee, please provide their full name.

Additional Information

What position are you applying for? *

What state(s) can you work in? *

Employment Desired Employment Desired

Are you at least 18 years old? *

Yes

No

Have you ever been employed at Broadband Service Group, Inc. before? If yes, please provide location and dates of employment.

Is there anything that would interfere with your regular attendance or punctuality?

Yes

No

Please explain what might interfere with your regular attendance or punctuality.

Are you legally eligible for employment in this country? *

Education

Please select highest level of education you completed:

Did you graduate?

Yes

No

Recent Employment #1

Please provide the following information about your recent employment starting with the most recent. If you do not have previous employment, enter “NONE” and today’s date in the required fields.

Title *

Company Name *

Date Employment Started *

Date Employment Finished *

Reason for leaving *

Final Rate of Pay *

Responsibilities and Duties *

Recent Employment #2

Title

Company Name

Date Employment Started

Date Employment Finished

Reason for leaving

Final Rate of Pay

Licenses and Certifications

Summarize any Training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

I certify that all answers given by me are true, accurate, and complete. I understand that the falsification, misrepresentation or omission of fact on this application (or any other accompanying or required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.
Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but it’s receipt does not imply that the applicant will be employed. I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation. If hired, I agree to abide by all the company rules and regulations, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the company or me. I further understand that no representation, whether oral or written by any representative or agent of the company, at any time, can constitute a contract of employment.
I understand that the company and all plan administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance, or otherwise change all policies, procedures, benefits, or other terms or conditions of employment. No representative or agent of the company, has the authority to enter into any agreement for employment for any specified period of time or to make any change in policy, procedure, benefit, or other term or condition of employment either than in a document signed by the President, or to make any agreement contrary to the foregoing.
By signing below, I hereby authorize Broadband Service Group, Inc. to contact my current and previous employers in an effort to gather the appropriate information for my employment eligibility. By signing below, I hereby release any and all personnel records, including performance reviews and motor vehicle reports.
I acknowledge that I have read and understand the above statements and herby grant permission to confirm the information supplied on this application by me.

Checkboxes *

I agree to the above application statement.

Disclosure: By using the Broadband Service Group, Inc. website, you agree to use an electronic signature in lieu of a paper based signature. You understand that electronic signatures are legally binding in the United States, just like you are signing on paper. You further agree not to electronically sign without first reading this form and ensuring that you have accurately completed the form to the best of your knowledge.

Candidate E-Signature *

Voluntary Equal Opportunity Questionnaire

As an equal opportunity employer, we hire without consideration to race, religion, creed color, national origin, age, gender, sexual orientation, marital status, veteran status or disability. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.

Gender

Male

Female

Race

Veteran / Disability

reCAPTCHA