Employment Application

Applicant Details

Employment Desired

Educational Background

Graduate School:

Job Experience

Note: We will contact the employers listed on this application unless you specifically exclude them below. (List below the last three employers, starting with the last one first)
Most recient/current position:

Previous Position:


Please list two professional references.


Military Service


Please Read and Initial Each Paragraph, then Sign Below
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring.
I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand
and that any omission (including any misstatement) of material fact on this application or on any document used to secure can be
grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.


I understand that if I am employed, my employment is not definite and can be terminated
by either me or the company at any time either with or without prior notice.

I permit the company to examine my references, record of employment, education record, and any other information I have
provided. I authorize the references I have listed to disclose any information related to my work record and my professional
experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

Applicant's Signature:



An Equal Opportunity Employer
Summit is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from
consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable
accommodation in the application and/or interview process should notify a representative of the organization