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

Additional Information


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.

Recent Employment #2

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.
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.

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.