First Name Middle Last Name
Position(s) Applied For
Social Security Number
Street Address
City/State/Zip Code
Home Phone
Mobile Phone
E-mail Address
Are you 18 or older? Yes No

Availability
Are you legally eligible for employment in this country? (Proof of citizenship or immigration status will be required upon employment.) Yes No
If you were offered a position, how soon would you be able to begin work?
What days would you be avaliable to work FT PT
Have you worked for the Lyons Group Before?

Yes No

If yes where and what position and reason for leaving
Have you ever served in the armed forces? (If yes, your service should be treated as employment and should be included below.) Yes No
Have you ever been convicted of any felony criminal offense, including military court convictions, since your 18th birthday? (Conviction will not necessarily disqualify you from employment.) Yes No

If yes, please explain:

Education
Do you have a high school diploma or GED certificate? Yes No
Last school grade completed
High school name and location
Schools attended after high school or special training received:
Name Location: City/state Graduate? Type of degree or diploma Major subjects
Yes No
Yes No
Yes No

Skills
Computers PC
Mac
Other Equipment
Software (list program names and years of experience)
Specialized training
Special qualifications, licenses, languages

Experience
List below your employment or work history beginning with your present or most recent job, including military service and pertinent volunteer service. Emphasize your specific tasks and supervisory, technical, or other responsibilities. Give special attention to experience relating to the job for which you are applying. Incomplete descriptions may result in lower ratings.
May we contact your present employer? Yes No
With my permission prior to offer
Employer Name Exact title of position
Supervisor's Name Address Telephone
From (mo/yr) To (mo/yr) Final Salary
Duties (be specific) Reason for leaving
Employer Name Exact title of position
Supervisor's Name Address Telephone
From (mo/yr) To (mo/yr) Final Salary
Duties (be specific) Reason for leaving
Employer Name Exact title of position
Supervisor's Name Address Telephone
From (mo/yr) To (mo/yr) Final Salary
Duties (be specific) Reason for leaving
Summary of other pertinent work experience:
Employer Position Title From/to

Submit Application
How did you learn of this position?
Please specify:
Any Additional Comments?
If you would like to include a cover letter and/or resume, you may include those here. We recommend you prepare these offline as text only, and then copy and paste the text in the boxes below. All formatting such as bullets and tables will be lost once you submit this application.
Cover Letter
 Resume

Please read the following carefully before completing your application:

Lyons Group adheres to a nondiscriminatory policy with respect to employment, enrollment, and program. Lyons Group does not discriminate on the basis of race, color, creed, religion, sex, national origin, age, handicap or disability, sexual orientation, or marital status and has a firm commitment to promote the letter and spirit of all equal opportunity and civil rights laws. Interviews are given on a competitive basis, using job-related factors, after a written application has been received and reviewed. Because of the large number of applications received, not everyone who applies for a vacant position will be interviewed.

I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any misrepresentation or material omission on this application will result in my being eliminated from further consideration. I further understand that, if accepted for employment, any misrepresentation or material omission that becomes known to Lyons Group will result in immediate termination of my employment.

I authorize the employers and supervisors listed in this application to give Lyons Group representatives any and all information regarding me and my previous employment. I release Lyons Group and all previous employers and supervisors from liability for any damages that may result from furnishing information to Lyons Group.

In consideration of my employment, I agree to conform to the instructions, rules, and policies of Lyons Group. My employment and compensation can be terminated at any time, with or without cause and with or without notice, at the option of either Lyons Group or myself. I understand that no representative of Lyons Group has authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.

Yes, I have read and agree to the above statement.