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Privacy Policy This privacy policy discloses the privacy practices for Provost & Pritchard Consulting Group. Provost & Pritchard take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline. We are the sole owners of the information collected on this form. We will not sell or rent this information to anyone. We will use your information to respond to you, but we will not share your information with any third party outside of our organization.

What position are you applying for?

Cover Letter (.pdf,.doc,.docx,.rtf)

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Resume (.pdf,.doc,.docx,.rtf)

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Name *

First

Last

Have you ever been employed or enrolled under another name? *

Yes
No

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

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Do you have a valid California Driver's License? *

Yes
No

Do you have any restrictions that could affect your use or Insurability of a company vehicle? *

Yes
No

Are you a citizen of the United States or do you have a legal right to work in the United States? *

Yes
No

Note: If hired, a Form I-9, Employment Eligibility Verification, must be completed at the start of employment

Are you able to lift up to 50lbs? *

Yes
No

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List the highest level of education first. Please note that no graduation year is required for high school.

Institutional Name

Level

Degree

Major

Graduated Year (mm-yyyy)

Would you like to add additional Education?

Add any Certifications

Certification

Certification Number

Certify State

Would you like to add additional Certifications?

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List three business professional references that have worked with you or affiliated with work you have done, and have known you for at least one year.

Reference #1

Name *

First

Last

Employer *

Title *

Phone *

Relationship *

Years known *

Reference Letter

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Reference #2 & #3

Layout

Name *

First

Last

Employer *

Title *

Phone *

Relationship *

Years known *

File Upload

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Name *

First

Last

Employer *

Title *

Phone *

Relationship *

Years known *

File Upload

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Employment History

May we contact your current / previous employer(s)?

Yes
No

Signature

List the most recent position first. Account for all periods of time.

Most Recent Employer

Company

Date Employed From

Date Employed to

Position

Address

Address Line 1

Address Line 2

City

State

Zip Code

Direct Supervisor

Phone

Reason for Leaving

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Federal Reporting Provost & Pritchard provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Provost & Pritchard complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. The firm is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, we invite you to voluntarily self-identify your race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders and regulations, including those which require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.

Please check the race/ethnic background with which you identify: *

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race.
White: a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American: a person having origins in any of the black racial groups of Africa
Asian: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Native Hawaiian or Other Pacific Islander: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
American Indian or Alaska Native: a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Two or More Races: a person who primarily identifies with two or more of the above race/ethnicity categories.
I prefer not to self-identify my race or ethnic background.

Please identify all categories that apply to you. *

Disabled Veteran: A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under the laws administered by the Secretary of Veterans Affairs, or a person who was discharged or released from active duty because of a service-connected disability.
Special Disabled Veteran: A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans’ Affairs for a disability a) rated at 30% or more, or b) rated at 10% or 20% in the case of a veteran who has been determined under Section 38 U.S.C. 3106 to have a serious employment handicap or a person who was discharged or released from active duty because of a service-connected disability.
Other Protected Veteran: A veteran who served on active duty in the U.S. military, ground, naval, or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran: A veteran who while serving on active duty in the U.S. military, ground, naval or air service, participated in a United Sates military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Recently Separated Veteran: A veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval or air service.
Vietnam Era Veteran: A veteran who served on active duty in the U.S. military, ground, naval or air service for a period of more than 180 days, and who was discharged or released there from with other than a dishonorable discharge, if any part of such active duty was performed; a) in a Republic of Vietnam between February 29, 1961, and May 7, 1975, or b) between August 5, 1964, and May 7, 1975, in all other cases; or was discharged or released from active duty in the U.S. military, ground, naval or air service for a service-connected disability if any part of such active duty was performed a) in the Republic of Vietnam between February 28, 1961, and May 7, 1975, or b) between August 5, 1964, and May 7, 1975, in any other location.
I prefer not to self-identify.
I am not a veteran.

Please provide date of discharge or release:

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Disclaimers

Initial *

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Initial *

I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

Initial *

I understand that nothing contained in the application, or conveyed during any interview, which, may be granted, or during my employment, if hired, is intended to create an employment contract between the company and me. In addition, I understand and agree that if I am employed, my employment is at will and is for no definite or determinable period and may be terminated at any time, with or without prior notice, or with or without cause, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company’s designated representative.

Initial *

I understand that in connection with my application for employment, depending upon the position for which I have applied, employment may be conditioned upon my taking and passing a post-offer drug test and, if necessary for the position for which I have applied, a post-offer medical examination. I understand that I may refuse to take any required pre-employment drug test and/or medical examination, but if I do, any offer of employment will be immediately withdrawn.

Initial *

This is to advise you that it is the Company’s policy to submit all employment-related disputes that cannot be resolved informally to binding arbitration. If you are offered a job with the Company, your hiring is conditioned upon your agreement to submit to any employment-related disputes you may have with the Company to arbitration. If you choose not to agree to binding arbitration, any offer of employment extended to you will be withdrawn.

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