On-line Employment Application

Thank you for completing our on-line employment application below. This information will be reviewed and kept on file a minimum of 6 months for employment evaluation and hiring purposes only. Business Integration Group is committed to Equal Employment Opportunity in both spirit and practice. It is our policy to afford equal opportunity for all employees without regard to race, color, religion, gender, age, national origin or veteran status. EEO - M/F/D/V

The following fields marked with an * are required.

Personal Information

*

First Name

M.I.

*

Last Name

Street 1
Street 2
City		State	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY	Zip Code

Contact Information

Home Phone #		Work Phone #
E-Mail		Home Page URL
Preferred Method of Contact:	-Select- Email Telephone Either

Are you a U.S. citizen or national; a permanent resident, a refugee, an asylee or authorized to work under the amnesty provisions of U.S. immigration law? (If you have non-immigrant status, for example, E-1, F-1, H-1, J-1, then your answer to this question should be no). Yes No

Are you bound by any contracts or agreements with a current or former employer that would prohibit or interfere with your employment with us? If yes, please briefly describe the terms of the contract:

Have you been convicted of a felony in the last 10 years? Yes No If yes, please explain:

How were you referred to us?