EMPLOYMENT APPLICATION

ACAMSis an Equal Opportunity Employer

POSITION APPLIED FOR:
If referred by a current ACAMS’ employee, indicate his/her name here: REFERRED BY:
CURRENT PERSONAL DATA

LAST NAME: FIRST: MIDDLE: ___

SOCIAL SECURITY NUMBER: E-MAIL: ______

HOME ADDRESS (Street Address):

CITY: STATE: ZIP:

MAILING ADDRESS (if other than street address)

CITY: STATE: ZIP:

HOME PHONE/CELL PHONE:

EMPLOYMENT AVAILABILITY

ARE YOU ABLE TO WORK: (Check all that apply)

 FULL-TIME  PART-TIME  SHIFTS  EVENINGS  WEEKENDS  HOLIDAYS  TEMPORARY

IF REQUESTED, WOULD YOU BE WILLING TO WORK OVERTIME OR OTHERWISE ADJUST YOUR WORK SCHEDULE TO MEET

COMPANY’S NEEDS?  YES  NO

SPECIFY ANY DAYS OR HOURS YOU ARE NOT AVAILABLE TO WORK

EARLIEST YOU WOULD BE ABLE TO START______SALARY DESIRED

ARE YOU OVER 18 YEARS OF AGE? YES  NO

ARE YOU PRESENTLY LEGALLY AUTHORIZED TO WORK IN THE UNITED STATES ON A FULL-TIME BASIS?  YES  NO

ADDITIONAL INFORMATION

HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENSE, HAD ADJUDICATION OF A CRIME WITHHELD, OR PLED NOLO CONTENDERE (NO CONTEST) TO ANY VIOLATION OF LAW, STATUTE OR ORDINANCE?  YES  NO

IF YES, PLEASE STATE YOUR AGE AT THE TIME OF THE OFFENSE, DATE OF THE OFFENSE, TYPE OF OFFENSE, DISPOSITION OF THE OFFENSE AND ANY REHABILITATION IN THE LINES PROVIDED BELOW. CONVICTION OF A CRIME WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT. THE ABOVE FACTORS WILL BE TAKEN INTO ACCOUNT IN DETERMINING THE EFFECT ON SUITABILITY FOR EMPLOYMENT.

HAVE YOU EVER BEEN A DEFENDANT IN A CIVIL ACTION FOR AN INTENTIONAL TORT (FOR EXAMPLE, ASSAULT, BATTERY, CONVERSION, DEFAMATION, FRAUD AND TRESPASS)?  YES  NO

IF YES, PLEASE EXPLAIN FULLY, INCLUDING THE ULTIMATE OUTCOME OF THE MATTER

EDUCATION
SCHOOL NAME/ADDRESS / ATTENDANCE DATES / DEGREE
GRADE SCHOOL
HIGH SCHOOL
COLLEGE/UNIVERSITY
GRADUATE SCHOOL
OTHER/GED
EMPLOYMENT HISTORY (THIS SECTION MUST BE COMPLETED EVEN IF ATTACHING RESUME)

INSTRUCTIONS: BEGINNING WITH YOUR PRESENT OR MOST RECENT EMPLOYER, LIST ALL FULL AND PART-TIME EMPLOYMENT FOR THE LAST TEN YEARS AND ACCOUNT FOR ALL GAPS IN EMPLOYMENT. USE ADDITIONAL SHEETS IF NECESSARY. IF YOU HAVE BEEN EMPLOYED UNDER OTHER NAMES, LIST THE NAME NEXT TO THE APPLICABLE EMPLOYER.

MAY ACAMS CONTACT YOUR PRESENT EMPLOYER? YES  NO

PRESENT/MOST RECENT EMPLOYER NAME:

STREET ADDRESS:

CITY, STATE, ZIP: TELEPHONE NUMBER:

JOB TITLE: SUPERVISOR'S NAME:

HIRE DATE: SEPARATION (END) DATE:

JOB DUTIES & RESPONSIBILITIES:

STARTING SALARY: ENDING SALARY:

REASON FOR LEAVING (Be specific, this area must be completed):

EMPLOYER NAME:

STREET ADDRESS:

CITY, STATE, ZIP: TELEPHONE NUMBER:

JOB TITLE: SUPERVISOR'S NAME:

HIRE DATE: SEPARATION (END) DATE:

JOB DUTIES & RESPONSIBILITIES:

STARTING SALARY: ENDING SALARY:

REASON FOR LEAVING (Be specific, this area must be completed):

EXPLAIN ALL GAPS IN EMPLOYMENT (if applicable)

ARE YOU RELATED TO ANYONE PRESENTLY EMPLOYED BY ACAMS?  YES  NO

IF YES, GIVE NAME AND RELATIONSHIP:

HAVE YOU EVER BEEN EMPLOYED BY ACAMS?  YES  NO

IF YES, COMPLETE THE FOLLOWING:

DATES PREVIOUSLY EMPLOYED: FROM ______TO ______POSITION TITLE ______

REASON FOR LEAVING: ______

SPECIAL TRAINING AND/OR CERTIFICATIONS

LIST ANY LICENSES, CERTIFICATES, OR ADDITIONAL TRAINING OR SPECIAL SKILLS, INCLUDING KNOWLEDGE OF COMPUTER PROGRAMS YOU HAVE THAT MAY BE HELPFUL IN CONSIDERING YOU FOR THIS JOB (FOR LICENSES OR CERTIFICATES INCLUDE DATE AND WHERE ISSUED):

LIST ANY PROFESSIONAL, TECHNICAL, OR TRADE ASSOCIATION OF WHICH YOU ARE A MEMBER: (You may omit those activities which indicate your race, age, religion creed, national origin, ancestry, sex, disability, or political persuasion).

REFERENCES

LIST THREE (3) PERSONAL OR PROFESSIONAL REFERENCES (NO RELATIVES OR EMPLOYERS)

NAME / OCCUPATION / TELEPHONE / YEARS KNOWN
CERTIFICATION

I CERTIFY THAT THERE ARE NO MISREPRESENTATIONS, OMISSIONS, OR FALSIFICATIONS IN THE STATEMENTS AND ANSWERS ON THIS APPLICATION AND THAT ALL THE FOREGOING ENTRIES MADE BY ME ARE TRUE, COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.

I UNDERSTAND THAT ALL JOB OFFERS FROM ACAMS ARE CONDITIONED ON THE SUCCESSFUL COMPLETION OF A BACKGROUND SCREENING.

I UNDERSTAND THAT ACAMS IS AN EQUAL OPPORTUNITY EMPLOYER AND DOES NOT DISCRIMINATE AGAINST OTHERWISE QUALIFIED APPLICANTS ON THE BASIS OF RACE, COLOR, CREED, RELIGION, ANCESTRY, AGE, SEX, MARITAL STATUS, NATIONAL ORIGIN, DISABILITY OR VETERAN STATUS. I UNDERSTAND THAT ACAMS WILL NOT TOLERATE UNLAWFUL DISCRIMINATION OR UNLAWFUL HARASSMENT AND THAT EMPLOYEES HAVE AN AFFIRMATIVE DUTY TO REPORT SUCH INCIDENTS AND THATSUCH CONDUCT IS GROUNDS FOR TERMINATION OF EMPLOYMENT.

I ALSO UNDERSTAND THAT EMPLOYMENT WITH ACAMS MAY BE TERMINATED WITHOUT CAUSE AND WITHOUT NOTICE BY EITHER PARTY AT ANY TIME.

I FURTHER UNDERSTAND AND AGREE IN ADVANCE THAT I MAY BE DISCHARGED OR ANY EMPLOYMENT OFFER MAY BE WITHDRAWN IF MY APPLICATION CONTAINS ANY MISREPRESENTATIONS OR FALSIFICATIONS OR IF ANY MATERIAL INFORMATION HAS BEEN OMITTED REGARDLESS OF WHEN THIS INFORMATION BECOMES KNOWN TO ACAMS.

I AGREE THAT IF HIRED BY ACAMS,UPON SEPARATION OF EMPLOYMENT, I SHALL RETURN ALL ACAMS’OWNED PROPERTY AND/OR EQUIPMENT.

I HEREBY SWEAR OR AFFIRM THAT I HAVE READ AND UNDERSTOOD THE STATEMENTS AND INSTRUCTIONS CONTAINED HEREIN AND HAVE ANSWERED ALL QUESTIONS COMPLETELY, ACCURATELY AND TRUTHFULLY.

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SIGNATURE DATE

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PRINT NAME HERE

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