General Application We are always looking for the right people for our team! Fill out the application below to be considered for our next position. - General Information -Should you need reasonable accommodation when completing the application form or during the selection process, contact the Human Resources Department or other designated company representative. Information provided on this application will be kept confidential and only be shared with those involved in the selection process. Please provide all information requested. Incomplete information may disqualify you from consideration. Lee Agency, Inc. is an Equal Opportunity Employer. Date* MM slash DD slash YYYY Name* First Middle Last Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Phone*Are you 18 years or older?* Yes No Are you legally Authorized to work in the United States?* Yes No As required by law, documents that prove identity and eligibility to work must be provided at the time of hire.Have you ever applied for employment with us before? If yes, please list the date below. Have you ever worked for us before? If yes, please provide your name of record at that time, job title and dates of employment.- Education -Highest Level of Education Completed*Graduate or Professional DegreeBachelorsAssociatesCurrent College/Trade School StudentHigh School Diploma/GEDSchool Name & Location (Of selected above)*- Employment History -Please provide your employment history, starting with your present or most recent position first.Has your employment with any employer ever been involuntarily terminated?* Yes No If yes, please identify the employer(s), date of termination(s) and reason(s) for termination.Name of Employer 1* Position* Dates Employed (From - To)* Reason For Leaving* Brief Description of Work and Responsibilities*If present employee, may we contact this employer?* Yes No Employer Email* Employer Phone*Supervisor Name* First Last Employer 2 InformationName of Employer 2* Position* Dates Employed (From - To)* Reason For Leaving* Brief Description of Work and Responsibilities*Employer Email* Employer Phone*Supervisor Name* First Last Employer Three InformationName of Employer 3 Position Dates Employed (From - To) Reason For Leaving Brief Description of Work and ResponsibilitiesEmployer Email Employer PhoneSupervisor Name First Last Please Upload Your Resume and/or Cover Letter Drop files here or Select files Max. file size: 300 MB. - Signature -APPLICANT: Please read the following carefully before signing this application. • I certify the information given by me is true in all respects. • I understand that the misrepresentation or omission of facts on this application, on my resume or during any stage of the hiring process may eliminate me from further consideration or if discovered after hire may result in the termination of my employment. • I understand that the information contained in this employment application or my being invited to participate in any stage of the hiring process is NOT intended to create an employment contract between this Company and myself. If an employment relationship is established, I understand that I have the right to terminate my employment at any time, for any reason or no reason, with or without notice, and this Company has the right to terminate my employment at any time, for any reason or no reason, with or without notice. This Company’s policies and procedures, including employment at-will, cannot be modified in any way without express written intent to do so by the senior business leader of this organization. • I understand that an offer of employment is contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States. • Unless otherwise noted above, I authorize this Company and its representatives to contact my prior employers, former supervisors and company personnel, schools and all others for the purpose of verifying the information I have supplied during the selection process and for obtaining job-related information regarding my knowledge, skills, abilities, performance of duties and compliance with policies. I authorize my prior employers to provide this Company any job-related information, personal or otherwise, they may have regarding me and I release this Company and them from any liability resulting from the release of this information. I further authorize all employers, schools and other persons to provide any information or transcripts that may be requested by this Company which will be used to determine if I am qualified to perform the job duties for which I am applying. • I understand that the company may conduct a criminal background investigation of me for the position for which I am applying and that a separate authorization to do so will be required. A conviction is not an automatic bar to consideration and/or employment. By placing my name below, I acknowledge that I have read and understand the above statements.Applicant's Electronic Signature* First Middle Last Date* MM slash DD slash YYYY Click Submit to Complete Application!Upon submitting this form, your application will be sent to a member of our HR team. We will reach out to you within the next two weeks. Thank you for your interest in our organization! Δ
