United States Senate Employment Division

Application for Employment

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age,
color, sex, religion, national origin, disability or other protected classifications. Please carefully read and answer all questions.
You will not be considered for employment if you fail to completely answer all the questions on this application. You may attach
a résumé, but all questions must be answered. Please also note that all positions require Registered Name Status (No “Guest_”
in front of your name)

Employer: Position Applying for:

United States Senate
Personal Information

*First Name: _____________________

Middle Name: __________________
*Last Name: _____________________
*Street Address: __________________
*City: ______________________
*State: ________
*Zip code: ________________
*Contact Email: _______________@________.________
*Date of Birth: ____/____/____
*Date Joined IMVU: ____/____/____
*Date available to start working: ____/____/____
*Position Information

Full Time Part Time Seasonal

Days Evenings
Weekends Holidays
United States Senate Employment Division

Have you ever been convicted of a felony? (Convictions will not necessarily
disqualify you for the position you are applying for) Yes No

If Yes, please explain the circumstances of your conviction:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Disabilities
Do you have any disabilities that prevent you from lifting 50lbs or more?
Yes No I do not wish to answer
Do you have any disabilities that prevent you from working?
Yes No I do not wish to answer
Veteran’s Status
Are you an employed or retired veteran of the United States?
Yes No I do not wish to answer
If Yes, which branch? __________________________________________
If yes, status? Employed Retired Discharged

Please note that we will check the validity of any claims made about a veteran’s
status. Not out of any disrespect, simply for our own verification. Please also
know that the aforementioned employer will NOT relay any of the information
you provided in this application to ANYONE without the consent of the applicant.
Disclosures and Signatures
United States Senate Employment Division

I certify that the facts set forth in this application for employment are true and
complete to the best of my knowledge. I understand that If I am employed, false
statements, omissions or misrepresentations may result in my dismissal. I
authorize the employer listed above to make an investigation of any of the facts
set forth in this application and release the employer from any liability. The
employer may contact any listed references on this application.

______________________________
Applicant’s Signature
_____/____/____
Date this application was submitted