Customer Service/Sales Representative

Employment / Job Application

Personal Information

* Indicates required field

Name *

First

Last

Date of Birth *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Social Security Number (SSN) *

Date Available to Start *

Willing to work Commission only? *

Position Applied For *

Employment Desired *

Full-Time Part-Time

Employment Eligibility

Are you a U.S. Citizen *

If no, are you allow to work in the U.S. *

Have you ever worked for BIS before *

If yes, write the start and end dates *

Have you ever been convicted of a felony? *

If yes, please explain: *

Education

High School *

City/State *

From *

To *

Did you graduate? *

College *

City/State *

From *

To *

Did you graduate? *

Did you earn a degree? *

If yes, please list *

Other *

City/State *

From *

To *

Degree/Certification *

Other *

City/State *

From *

To *

Degree/Certification *

Employment History

Employer #1 *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Starting Pay *

Ending Pay *

Job Title *

Responsibilities *

Starting date *

Ending date *

Reason for leaving *

Employer #2 *

Email (E2) *

Phone Number (E2) *

Address (E2) *

Line 1

Line 2

City

State

Zip Code

Country

Starting Pay (E2) *

Ending Pay (E2) *

Job Title (E2) *

Responsibilities (E2) *

Starting date (E2) *

Ending date (E2) *

Reason for leaving (E2) *

Employer #3 *

Email (E3) *

Phone Number (E3) *

Address (E3) *

Line 1

Line 2

City

State

Zip Code

Country

Starting Pay (E3) *

Ending Pay (E3) *

Job Title (E3) *

Responsibilities (E3) *

Starting date (E3) *

Ending date (E3) *

Reason for leaving (E3) *

References

Reference #1 *

Relationship *

Company *

Title *

Email *

Phone Number *

Reference #2 *

Relationship (R2) *

Company (R2) *

Title (R2) *

Email (R2) *

Phone Number (R2) *

Reference #3 *

Relationship (R3) *

Company (R3) *

Title (R3) *

Email (R3) *

Phone Number (R3) *

Military Service

Are you a veteran? *

Branch *

Rank at discharge *

Starting Date *

Ending Date *

Type of discharge *

If not honorable, please explain *

Background Check Consent

If asked, are you willing to consent to a background check? *

Yes No

Disclaimer

Applicant understands that this is an equal opportunity employer and committed to excellence through diversity. In order to ensure this application is acceptable, please print or type with the application being fully completed in order for it to be considered.

I, the applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.

Name *

Date *

Submit

We are licensed in Texas, Florida, Michigan, Kansas, Nebraska, Iowa, Arizona, and Alabama.