Turquoise Broadcasting Co. LLC
PO BOX 64125, Tucson, AZ 85728
Phone: 520-360-5225
Applicant Information
Last Name First Name Middle Initial
Home Address
City State Zip
Telephone Number Social Security Number
Emergency Contact Name
Emergency Contact Telephone Number
Do you have the legal right to work in the United States? Yes No
Are you currently employed? Yes No May we contact? Yes No
If yes, state the name, address and telephone number of your current employer:
Are you over the age of 18? Yes No If no, state your age:
Have you been convicted of a felony within the past ten (10) years bearing a rational or reasonable relationship to the duties and responsibilities of the position for which you are applying? Yes No
If yes, please explain:
Have you been convicted of a misdemeanor within the past ten (10) years bearing a rational or reasonable relationship to the duties and responsibilities of the position for which you are applying? Yes No
If yes, please explain:
Are you interested in: Full-time work or Part-time Work?
Please list the days you can work: Sun Mon Tue Wed Thu Fri Sat
Please list the hours you can work:
Date Available: Desired Pay:
Have you ever been employed by TBC Radio? Yes No If yes, when?
State the names of any relatives/friends in our employ:
How did you hear about this position?
Education
School Name City/State Major GPA Degree
High School
College
Trade/Other
List any special training or education you have received:
Experience
Most Recent Job Next Most Recent Job Third Most Recent Job
From /To:
Title / Position
Company / Division
Type of Business
Address
City / State
Phone Number
Rate of Pay
Job Duties
Supervisor / Title
May TBC Radio contact
your previous employers? Yes No Yes No Yes No
List your skills:
References
I hereby authorize New Northwest Broadcasters, LLC to contact any of the references listed below:
Company Name: Address:
Supervisor's Name: Phone No:
Company Name: Address:
Supervisor's Name: Phone No:
Company Name: Address:
Supervisor's Name: Phone No:
The information I have provided on this form is true and correct to the best of my knowledge. Any misrepresentation or omission of fact can be justification for immediate disciplinary action, up to and including termination. I agree to comply with the policies and procedures of TBC Radio and understand that my employment and compensation are at will and can be terminated with or without notice, and with or without cause, at any time, at the option of TBC Radio or myself.
It is understood that the applicant will maintain Confidentiality regarding any proprietary information belonging to TBC Radio. Such information may include, but is not limited to: client lists, personnel information, compensation, internal communications, computer programs, price lists, business plans, financial statements, law suits, or other legal proceedings.
Signature
Printed Name Date