Online Job Application Step 1 of 5 20% APPLICATION FOR EMPLOYMENT EQUAL OPPORTUNITY EMPLOYER MobilityWorks/Driverge is an Equal Opportunity Employer. All applicants will be considered for employment without regard to their race, color, creed, religion, national origin, ancestry, alienage or citizenship status, age, disability, gender (including pregnancy, childbirth and related medical conditions), sexual orientation, genetic information/characteristics, veteran status, marital status or any other class protected by federal, state, or local laws. Any offer of employment from MobilityWorks/Driverge. may be subject to successful completion of a criminal background check, motor vehicle check, employment reference check, drug test, and/or credit check, depending upon the job duties of the position offered. We will endeavor to make a reasonable accommodation/modification to the known physical or mental limitations of a qualified applicant with a disability to assist in the hiring process, unless the accommodation would impose an undue hardship on the operation of our business, in accordance with applicable federal, state and local law. If you believe you require such assistance to complete this form or to participate in the interview process, please contact Jillian Montmarquet, Human Resources Director at (603) 437-4444Personal InformationDesired Starting SalaryDate Available* Date Format: MM slash DD slash YYYY Today's Date* Date Format: MM slash DD slash YYYY Name* First Last Email* Phone*How were you referred to us?Present Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Position applying for or area of work you are interested in*Position Location*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificSelect the state in which the position is available in or the state you wish to submit an application for.Are you legally authorized to work in the United States?*As a condition of employment, all employees are required to submit proof of employment and identity in compliance with the Immigration Reform and Control Act of 1986.YesNoWe are sorry but based upon your selection we cannot consider your application for employment. Please contact the HR Department at 603-437-4444 for further explanation. Are you over the age of eighteen?*YesNoIf no, hire is subject to verification that you are of minimum legal age for the applicable position.We are sorry but based upon your selection we cannot consider your application for employment. Please contact the HR Department at 603-437-4444 for further explanation.Have you ever applied to or been employed by MobilityWorks?YesNoIf yes, when and what position?Have you signed any non-compete or non-solicit agreement with any other employer that might restrict you from working for MobilityWorks?*YesNoIf yes, please explain*you may be required to furnish a copy of the agreement EducationFirst select any types of schooling that apply and then fill out the fields that appear.Type of Schooling*Please select any partial or completed schooling High School College or University Graduate or Business School Trade School Name of High School*Highest Level of High School Education*Graduated DiplomaGeneral Education Degree (GED)Name of College or University*Highest Level of College Education*CertificateAssociatesBachelorsMastersDoctoralName of Graduate or Business School*Name of Trade School*Continuing Education / Certifications Employment HistoryPlease provide your employment history below, if you have more than 3 feel free to provide an attached file at the end of this application.Employer 1*From Date* Date Format: MM slash DD slash YYYY select 1 for day if unknown. example: mm/01/yyyyTo Date* Date Format: MM slash DD slash YYYY select 1 for day if unknown. example: mm/01/yyyyYour Job Title*Reason For Leaving*Duties / Responsibilities*What were your duties or responsibilities at this positionEmployer 2From Date Date Format: MM slash DD slash YYYY select 1 for day if unknown. example: mm/01/yyyyTo Date Date Format: MM slash DD slash YYYY select 1 for day if unknown. example: mm/01/yyyyYour Job TitleReason for LeavingDuties / ResponsibilitiesWhat were your duties or responsibilities at this positionEmployer 3From Date Date Format: MM slash DD slash YYYY select 1 for day if unknown. example: mm/01/yyyyTo Date Date Format: MM slash DD slash YYYY select 1 for day if unknown. example: mm/01/yyyyYour Job TitleReason for LeavingDuties / ResponsibilitiesWhat were your duties or responsibilities at this position Certification and AgreementPlease attach any additional files here Drop files here or Accepted file types: pdf. Cover Letter, Resume, CV, etc. Your attachments must be in PDF format. If you have a Word doc you should be able to use Save As to save it as a PDF. If you are having issue upload you may email you resume to firstname.lastname@example.orgI solemnly swear and certify that all answers given in this application are true and complete to the best of my knowledge and belief. In the event of an offer of employment and/or subsequent employment, I understand that false, misleading or omitted information in my application shall be grounds for withdrawal of an offer of employment or discharge at any time. It is my understanding that MobilityWorks/Driverge, or its agents, may make a thorough investigation of my entire work and personal history and may verify all data given in my application for employment, related papers or oral interviews. I understand that MobilityWorks/Driverge, or its agents, may disclose to third parties some or all of the information given in my application as part of the background investigation. I authorize such investigation and the giving and receiving of any information requested by MobilityWorks/Driverge, or its agents, and I release from liability any person or organization giving or receiving any such information. I understand that this is an application for employment and that no employment contract or promise of employment is being made. I understand that if I am employed, such employment is for no definite period of time and that MobilityWorks/Driverge, can change wages, benefits, practices, policies and conditions at any time. No application, brochure, policy statement, procedure, benefit plan, summary, work rules, employee handbook, or other written or oral communication between the company and its employees is intended to create an employment contract other than an “at will” employment relationship. I further agree that the “at will” employment relationship means that both the company and the employee have the right to terminate the relationship without recourse or liability at any time with or without cause and with or without notice. I fully understand and agree that if employed by MobilityWorks/Driverge, I am an “at will” employee. I further understand that only the President and/or Vice President of MobilityWorks/Driverge has the authority to make any agreement to the contrary. I agree to comply with and acknowledge the procedures, policies and practices of MobilityWorks/Driverge in accordance with applicable law. In addition, I understand that MobilityWorks/Driverge and all plan administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms and conditions of employment. If hired, I understand that proof of authorization to work in the U.S. will be required in accordance with applicable law. I further understand, if hired, MobilityWorks/Driverge may request that I execute other documents (including, but not limited to, agreements regarding training, trade secrets, confidential information and conflicts of interest). I also certify that there is no agreement outstanding with any third party or any other legal requirement (ie Non-Competition Agreement) which would prevent me from accepting employment with MobilityWorks/Driverge, Inc. or would otherwise adversely affect such employment. I understand and agree that any causes of action or claims that I may have or bring against MobilityWorks/Driverge must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary. I waive the right to a jury trial for any claims that I may have against the Company and agree to submit all such claims for resolution by a judge serving without a jury in the appropriate court with jurisdiction over the matter. Verify* I have read the understand the above Please provide your Signature* Please review your information below and click submit to send your request.