Personal Information

    Are you authorized to work in the U.S.?
    Have you ever been convicted of a felony?






    Check all days and times that apply.


    Add any high schools, colleges, and trade schools.
    + Add School


    Add at least 1 employer.
    + Add Employer


    Add your professional references. Do not include friends or relatives.
    + Add Reference
    How were you referred to us?
    Do you wish to work:
    Are you available to travel?


    In connection with my application for employment and as a condition of continuing employment, I understand that investigative background inquiries may be made on me including previous employers, schools, consumer credit, criminal convictions, motor vehicle, and other reports. These reports will include information as to my character, work habits, performance, education, compensation and experience along with reasons for termination of employment from previous employers. Furthermore, I understand that the company may be requesting information from various federal, state and other agencies, which maintain records concerning my past activities relating to my driving, credit, criminal, civil and other experiences as well as claims involving me in the files of insurance companies. I authorize with reservation, any party or agency contacted to furnish the above-mentioned information and release all parties involved from liability and responsibility for doing so. I hereby consent to obtaining the above information by NFMC and/or any of their agents. This authorization and consent shall be valid in original, fax or copy form.

    I understand this application is not an employment contract, nor can it be used to create one. Employment by NFMC has no specific term and may be terminated by the employee or NFMC with or without notice. I acknowledge that NFMC has not made any promises or representations that differ from those contained in this paragraph.

    I understand that I must provide satisfactory documents to establish my identity and right to work in the United States, if I am offered a position with NFMC, and that failure to provide this evidence will result in the termination of my employment.

    I release and agree to hold harmless an individual, company, business institution or government agency from all liability with regard to furnishing information to NFMC. I agree and hold harmless NFMC from all liability with respect to the receipt of such information.

    I certify that the information I have furnished on this application form is true and complete. I understand that if any misrepresentation has been made by me verbally or in writing, any offer or employment made to me may be withdrawn or my subsequent employment with NFMC may be terminated.

    Digital Signature