FEATURED CANDIDATE EMPLOYMENT APPLICATION
PERSONAL INFORMATION
Eternity Marketing Group, Inc. is an equal opportunity employer.  All personal information disclosed is not used for
discrimination purposes, but so we may place you in an applicable position.  All fields are optional.
FIRST AND LAST NAME
 EMAIL ADDRESS
PHONE NUMBER (DAY)
ALT. NUMBER
ADDRESS
CITY, STATE ZIP CODE
I.D or DRIVERS LICENSE NUMBER
SOCIAL SECURITY NUMBER
 STATE ISSUED
DATE OF BIRTH
LIVE-IN OR LIVE-OUT
LOCATION
POSITION APPLYING FOR
SALARY OF LAST EMPLOYMENT
EXPECTED SALARY:
PREVIOUS WORK HISTORY
START FROM MOST RECENT
EMPLOYERS NAME
PHONE NUMBER
CITY, STATE
EMPLOYMENT DATES
REASON FOR LEAVING
POSITION HELD
EMPLOYERS NAME
PHONE NUMBER
CITY, STATE
REASON FOR LEAVING
EMPLOYMENT DATES
POSITION HELD
EMPLOYERS NAME
 CITY, STATE
 PHONE NUMBER
REASON FOR LEAVING
EMPLOYMENT DATES
 POSITION HELD
EDUCATION
HIGHEST LEVEL OF EDUCATION COMPLETED
ARE YOU IN SCHOOL?
GENERAL INFORMATION
IF YES, PLEASE LIST YEAR/MAKE/MODEL
DO YOU HAVE A CAR?
DO YOU HAVE INSURANCE?
 IF YES, NAME OF COMPANY
ARE YOU A LEGAL CITIZEN?  (PROOF OF CITIZENSHIP IS REQUIRED)
ARE YOU WILLING TO WORK IN A HOME WITH CHILDREN?  IF YES, WHAT AGES.
HAVE YOU EVER BEEN CONVICTED OR ARRESTED FOR DRIVING
UNDER THE INFLUENCE OF DRUGS OR ALCOHOL?  IF YES, EXPLAIN
HAVE YOU EVER BEEN ARRESTED OR CONVICTED FOR HAVING AN
IMPROPER SEXUAL OR PHYSICAL CONTACT WITH ANYONE?  IF YES,
EXPLAIN.
HAVE YOU EVER BEEN ARRESTED OR CONVICTED FOR THEFT,
EMBEZZLEMENT OR ANY OTHER CRIMINAL ACTIVITIES?  IF YES,
EXPLAIN.
DO YOU HAVE OR HAVE YOU HAD ANY PHYSICAL OR MENTAL
AILMENT THAT WOULD PREVENT OR HENDER YOU FROM
PERFORMING THE REGULAR WORK DUTIES YOU ARE APPLYING
FOR?  IF YES, EXPLAIN.  
ARE YOU UNDER THE CARE OF ANY PHYSICIAN?  IF
YES, EXPLAIN
DO YOU SMOKE?
CONFIDENTIALITY AGREEMENT
Confidentiality begins even before a position is accepted.  Employees owe employers and families the
obligation not to reveal confidential information without their expressed and written permission.

The employment setting is a private home, therefore there are many opportunities to become aware of
the clients or employers business household affairs, habits, and personal details of everyday living
and childcare.

Maintaining confidentiality is expected and is considered unethical to reveal private matters.

Upon termination of employment, confidentiality with employer must be maintained.  It also extends
concerning the privacy of Eternity Marketing Group, Inc. executives, colleagues, and co-workers.  
Please type in your name as to legally acknowledge the understanding and  
compliance of the Confidentiality Agreement.
STATEMENT OF UNDERSTANDINGS
Please read and initial each one.
I understand that should the client choose to hire me, the client must first pay EMG’s fee, and EMG
will notify me via personal phone call, E-mail, certified letter or fax, of my first official work day.
I understand that if I continue to work for the client without EMG notifying me to do so, I am now liable
for the clients’ fee. I understand that if necessary, EMG will pursue all legal resources necessary to
collect client’s fee, not limited to prosecution.  I also understand that I am responsible for all legal
court and attorneys fees.
I understand that I authorize EMG to distribute, copy, transmit by facsimile or otherwise, to the extent
legally allowed, the information about me to potential employers.
I understand that if I accept a position and decide to quit for any reason, I MUST give a one week
notice.  Failure to give a one week notice will permanently terminate my membership with EMG.   I
also understand that if I am fired within 90 days of my probationary period, I am not entitled to any
severance pay.
I agree to hold EMG harmless from any and all claims against it as a result of my acts and/or conduct,
and I agree to fully indemnify EMG for all claims for damages which are a direct or indirect result of my
errors and /or omissions.  I further release EMG from all claims for personal injuries and damages as a
result of this placement, including any claims allegedly caused by the negligence of EMG.
I agree that I shall not provide to clients any referrals, including friends or relatives as
potential employees.   I also agree not to contact or solicit any of the client's friends,
relatives, or business associates for future employment opportunities.
This agreement shall be construed and enforced in accordance with the laws of the state.
If any term of this Agreement is held by a court of competent jurisdiction to be invalid or unenforceable, then this
Agreement, including all of the remaining terms, will remain in full force and effect as if such invalid or enforceable
term had never been included.
Please type in your name as to legally acknowledge the understanding
and compliance of the Statement of Understanding.
I hereby agree that all information written is true and accurate.  I understand that any false information will lead to
immediate termination at any time during employment.
Please type in your name as to legally acknowledge the understanding
of Employment Application.
REFERENCES
Please includes references from past employment only!
NAME
 PHONE
 POSITION HELD
NAME
PHONE
POSITION HELD
PHONE
POSITION HELD
NAME
EMERGENCY CONTACT
NAME
ADDRESS
PHONE
ALT. PHONE
RELATIONSHIP
Please include any additional comments (including additional languages) that you would like to add, that would assist us in
finding you the ideal position.
Are you CPR/First Aid certified?
Position location and family (if applicable)
Thank you for your interest in receiving employment through our agency
EMG International Domestic Search Firm!
Please click on the submit button to begin processing
your payment of $25.00 to become a Featured Candidate.
Copyright © 2005-2012 Eternity Marketing Group, Inc. All rights reserved.
EMG
INTERNATIONAL DOMESTIC SEARCH FIRM
There is a $25.00 Application Fee for Featured Candidates