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Careers at National

Application for Employment

113 Corporate Park E Dr. · LaGrange, GA 30241 · (800) 292-9323

Equal Opportunity Employer — All applicants considered without discrimination

Website

Personal Information

Last Name *

First Name *

Middle Name / Initial

Application Date *

Age Required only if under 18

Email Address *

Phone Number *

No.

Street *

City *

State *

Zip

Position Applied For *

Rate of Pay Expected

Work Type Preferred *

Full-Time Part-Time

If Part-Time, specify days/hours

Will you work overtime whenever necessary? *

Yes No

Previously employed by National Management Resources?

Yes No

If considered, what date will you be available to start? *

Any experience, skills, or qualifications? *

Are you presently able to perform all essential duties of the position? *

Yes No

Are you able to stand or sit for extended periods? *

Yes No

Do you have a valid driver's license? (if position requires driving) *

Yes No N/A

Are you a U.S. citizen or otherwise eligible to work in the United States? *

Yes No

Proof of identity and eligibility required prior to employment.

Record of Education

School Name & AddressCourse of StudyLast Year CompletedGraduation DateDiploma / Degree

High School

College

Other

Employment History

1Most Recent Employer

Are you currently working for this employer?

Yes No

May we contact? Yes No

Company Name

State

City

Phone No.

Fax Number

Job Title

Dates Employed: From

To

Salary

Supervisor's Name

Duties

Reason for Leaving

2Second Most Recent Employer

Are you currently working for this employer?

Yes No

May we contact? Yes No

Company Name

State

City

Phone No.

Fax Number

Job Title

Dates Employed: From

To

Salary

Supervisor's Name

Duties

Reason for Leaving

3Third Most Recent Employer

Are you currently working for this employer?

Yes No

May we contact? Yes No

Company Name

State

City

Phone No.

Fax Number

Job Title

Dates Employed: From

To

Salary

Supervisor's Name

Duties

Reason for Leaving

Personal References

Please provide three professional or personal references (not family members).

Reference 1 — Name & Occupation

Phone No.

Reference 2 — Name & Occupation

Phone No.

Reference 3 — Name & Occupation

Phone No.

Military Service Record

Were you in the U.S. Armed Forces?

Yes No

Dates of Duty: From

To

Rank at Discharge

Duties in service, including special training

Have you taken any training under the G.I. Bill of Rights?

Yes No

Cover Letter & Resume

Accepted formats: PDF, DOC, DOCX, or RTF — up to 5 MB each.

Cover Letter Optional Choose a file or drag it here

Resume Optional Choose a file or drag it here

Certification & Signature

The facts set forth in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and any of the information that I have provided on this application. I hereby authorize any former employer, person, firm, corporation or government agency to answer any and all questions and release or provide any information within their knowledge or records, and I agree to hold any or all of them blameless and free of any liability for releasing any truthful information that is within their knowledge of records.

Applicant Signature (type full name) *

Date Signed *

I certify that all information is true and accurate and I authorize National Management Resources Corporation to verify my background and references.

Fields marked * are required. Your application and documents are submitted securely to our HR team.

Equal Opportunity Employer — All qualified applicants receive consideration regardless of race, religion, sex, national origin, citizenship, disability, or any other protected status.

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