Online Application

Your Full Name

E-mail Address

Home Address (including City, State, Zipcode)

Home Phone:

Work Phone Number:

What Job Do You Want?

What Date Can You Begin Work?

Complete this section if you are not applying for an executive, managerial or professional position.

What days and hours can you work?
Full Time: yesno

Part Time – Please indicate the days and hours preferred.

If part time, are you able to be flexible in your hours?
YesNo

If No, I can not work the following hours:

Can you work overtime?
YesNo

Can you work weekends, if you are needed?
YesNo

Do you know anyone employed at Great American Title Company?
YesNo

If yes, who do you know?

Are you legally entitled to work in the United States?
YesNo

(All applicants who receive job offers must complete forms I-9 and identification to verify they may work in the U.S.)

Has your Escrow Officer license or Driver license in any state ever been surrendered, denied, suspended, revoked, restricted, investigated or placed on probation?
YesNo

If yes, please state what happened:

Have you ever been convicted of a crime?
YesNo

If yes, provide the following information:
1.) Charge, 2.) Conviction date, 3.) Place, 4.) Court, and 5.) Sentence Imposed or Other Action Taken:

Education & Training

High School (Include Name of School, State, Course or Major Studied, Years Completed, and Diploma/Degree)

College (Include Name of School, State, Course or Major Studied, Years Completed, and Diploma/Degree)

Other (Include Name of School, State, Course or Major Studied, Years Completed, and Diploma/Degree)

Do you have any training that is relevant to the job you want, such as special training program, or armed forces training?
YesNo

If you do, please briefly describe the training

Can you do all the parts of each job you have applied for?
YesNo

If you can not do any part of any job you have applied for, please describe the things you can not do and describe anything the Company could do so you could do all the parts of the job

Employment History

List each job you have held, starting with your present or most recent job. Include any military service and volunteer activities that apply to the job you want.

Employer 1

From: Month/Year

To: Month/Year

Work Performed:

Home Address (including City, State, Zipcode)

Supervisor’s Name

State why you left or were terminated:

Person to contact for reference, title and phone number:

Employer 2

From: Month/Year

To: Month/Year

Work Performed:

Home Address (including City, State, Zipcode)

Supervisor’s Name

State why you left or were terminated:

Person to contact for reference, title and phone number:

Employer 3

From: Month/Year

To: Month/Year

Work Performed:

Home Address (including City, State, Zipcode)

Supervisor’s Name

State why you left or were terminated:

Person to contact for reference, title and phone number:

Do you have work experience before #3 above? If you do, please describe any other work experience that is relevant to the
Job you want:

• At-Will Employment. I agree that this application for employment does not create a contract of employment between the Company and me; and I understand that if I am hired, I will be an “at-will” employee throughout my time with the Company, which means either the Company or I may terminate the employment relationship with or without cause at any time, with or without advance notice. I further understand that only the Company’s Chairman or President has the authority to change the at-will employment of any applicant or any employee, and that the Chairman or President may do so only in writing; so I may not rely on any written assurance from any other person or on the verbal assurance, conduct or custom of any person regarding the term or any other condition of my employment.

• All Application Information is Truthful and Complete. I affirmatively represent that all the information I have provided on this Application and have provided and will provide in seeking employment with the Company is truthful and complete. I understand that if I misstate or fail to state any fact in applying with the Company, I could be disqualified from consideration for employment or, if I am employed, I could be discharged. I therefore agree that, if I provide false information, conceal information, or cause or authorize anyone else to provide any false information or to conceal information in connection with my application for employment, the company will have to no liability for hiring me based on such false or incomplete information. If the company determines that the information given in the application was falsely given and the applicant has been hired for employment, the Company has the right to discharge the applicant for falsifying this application.

• The Company May Make Inquiries. I agree that the Company may make such inquires of me, my references, prior employers and any third party it deems appropriate to verify and evaluate my qualifications to carry out the duties of the position for which I am applying.

• An Equal Opportunity Employer. Great American Title Company is an equal opportunity employer. This application will not be used for limiting or excluding any applicant for consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.

• I understand and agree that, if I am hired by the Company.

1.) I will need to supply documents for inspection and copying to verify my identity and my legal ability to work in the United States.
2.) I will need to update any information on my employment application or forms that change.
3.) The Company in its sole discretion may at any time change its personnel policies and may also change my job responsibilities, wages and benefits.
4.) The Company has no-smoking policy and prohibits smoking inside the Company’s offices and facilities at all times.

• The follow agreement applies if this box is checked:
Yes

• Pre-Employment Drug Screening Test.

I understand that, subject to applicable law, the Company requires every applicant who receives a job offer for the position(s) I am seeking to be tested to screen for current use of illegal drugs. I also understand that the testing will be performed at the Company’s expense, requires applicants to give body substances (e.g. breath, urine, blood) and is performed at a testing facility the Company designates. I also understand that the Company will not offer employment to anyone who fails or refuses to take the drug screening test. I therefore agree I will submit to drug screen testing as part of my application and that the Company will have no liability to me related to such testing or for refusing to employ me if I fail the test.

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Applicant E-Signature (Type Your Full Name)

Date

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