Job Application

Name*
First Middle Initial Last
Phone (best way to reach you)*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Position*
Date you can start*
Salary Desired*
Are you employed now?*
- Yes
- No
May we contact your present employer?
- Yes
- No
Are you currently on "lay-off" status and subject to recall?*
- Yes
- No
How did you hear about us?

Work History and References*
How would you prefer to send us your work history and references?
- I will fill out my work history and references using this form
- I will upload my resumé
- I will email my resumé
Click "Choose File" below to upload your resume*
Accepted file types: pdf, doc.
Please attach your resume in PDF or Word document format and send to contact@premiercb.com
Email*
Please provide us your email so we can contact you, if necessary.
Former Employers
Please fill out the following information:
Former Employers*
Name and Address of Employer Dates Employed (Month & Year) Salary Position Reason for Leaving
Special Skills and Qualifications*
References*
Name Address Telephone #

Premier Code of Conduct & Commitment to Unity

The Power of Unity How am I becoming part of the solution?

Go For It! Will Premier’s opportunities bring out the best in me?

Mutual Respect Willingness to Help. Readiness to Listen. Eagerness to Honor.

Gossip Be a home run hitter—don’t give in to complaining or gossip!

Communication Do I communicate “I need you” or “I can do it myself”?

Humility “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” (Ernest Hemingway)

Teamwork Am I holding the light bulb or having an adventure changing it?
Application Agreement*
You must check both boxes below.
- "I certify that the facts contained in this application are true and complete to the best of my knowledge."
- "I acknowledge that Premier is a drug and alcohol-free workplace. I acknowledge that all applicants and employees are subject to substance abuse testing as a condition of hiring and continued employment."
- "I have read and agree to Premier's Code of Conduct."

Former Employers

Name and Address of Employer	Dates Employed (Month & Year)	Salary	Position	Reason for Leaving

Name	Address	Telephone #