Branz Employment Application

First name
Last name
Multi-line address
Country/Region
Address
City
Zip / Postal code
Email
Phone

Education

  • Did not complete high school
  • High school diploma or equivalent
  • Some college
  • College graduate

Employment History (last five years, including military)

Employer #1*

  • Title*

  • Salary*

  • Start and End Dates*

    • Still Employed
    • Resigned
    • Terminated

Employer #2

  • Title

  • Salary

  • Start and End Dates

    • Still Employed
    • Resigned
    • Terminated

Employer

  • Title

  • Salary

  • Start and End Dates

    • Still Employed
    • Resigned
    • Terminated

Additional Employment Remarks
I am legally authorized to work for Branz Technologies, Inc in the United States.*

WILL YOU NOW OR IN THE FUTURE REQUIRE BRANZ TECHNOLOGIES, INC. TO COMMENCE ("SPONSOR") AN IMMIGRATION CASE IN ORDER TO EMPLOY YOU (FOR EXAMPLE, H-1B) OR OTHER EMPLOYMENT-BASED IMMIGRATION CASE?*

  • Yes
  • No

What Position are You Applying For*

If Part Time Please List Your Days and Hours of Availability

Expected Salary*

I HAVE A VALID DRIVER'S LICENSE*

  • Yes
  • No

I UNDERSTAND THAT ANY MISREPRESENTATION, FALSIFICATION OR OMISSION OF THIS APPLICATION SHALL BE SUFFICIENT REASON FOR REFUSAL OR DISMISSAL OF MY EMPLOYMENT. I HEREBY AUTHORIZE INVESTIGATION OF ALL MATTERS CONTAINED IN THIS APPLICATION.

Date*

  • Month
  • Day
  • Year

Signature*
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