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Employment Application

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General Information
First Name:
Last Name:
Middle Initial:

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Current Address
Address:
City:
State:
Zip:

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Contact Info
Primary (Cell or Home) Phone:
Secondary Phone Number:
Work Phone:
Email Address:

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Education
High School Name:
High School Years Completed:
Did you graduate?:
High School Diploma or Degree recieved:
College Name:
College School years completed:
Did you graduate college?:
Other Special Skills and/ or Training:

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General Questions
Do you have CUBS Experience?:
Have you ever applied to Niagara Credit Solutions, Inc. Before? :
How did you hear about Niagara Credit Solutions, Inc?:
Have you ever been convicted of a crime involving any violent or dishonest act, or use or possesion of a weapon? :
Are you currently out on bail, the subject of a current warrant for arrest or released pending a trial? :
Is there any legal reason that would prevent you from accepting immediate employment with NCSI? :
Are you currently under a non-disclosure, non-compete or non-solicitation agreement with another company? :
Have you ever been terminated for reasons of insubordination, performance or violation of company policy?:
Have you ever resigned in lieu of termination?:
Have you ever worked for NCSI or an affiliate?:
List any friends or relatives employed by NCSI.:

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Former Employment
Most Recent or Current Employer Name:
Are you currently employed?:
Company Address:
Company City:
Company State:
Company Zip:
CompanyPhone:
Company Supervisor Supervisor Name:
Company Supervisor Title:
Company Supervisor Telephone Number:
Job Title:
May we contact this employer?:
Second most recent employer name:
Company Address:
Company City:
Company State:
Company Zip:
Company Phone:
Company Supervisor Supervisor Name:
Company Supervisor Title:
Company Supervisor Telephone Number:
Job Title:
May we contact this employer?:

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Niagara Credit Solutions, Inc. is an Equal Opportunity Employer

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