Call Center Representatives

-- High School Some College College Degree Post Graduate

Have you ever applied/worked for Intercept before?
No Applied Worked

Do you have friends/relatives/acquaintances currently working or that have worked in the past in the company? Yes No

Have you been convicted of a felony within the last 10 years?

Have you ever been a party to a lawsuit (either as plaintiff or defendant)?

List the last three places where you have worked, starting with the most recent, and the reason for leaving:

List the last places where you have lived in the past 5 years:

From To

From To

From To

From To

From To

Please list the days/times available to work.

Monday to

Tuesday to

Wednesday to

Thursday to

Friday to

Saturday to

Sunday to

Able to work split schedule? Yes No

Resume:

Type of employment desired: Full-Time Part-Time Seasonal

Are you currently employed? Yes No

If so, may we contact your current employer? Yes No

Yes I AUTHORIZE INTERCEPT OF FLORIDA OR ITS DESIGNATED AGENTS TO CONDUCT A COMPREHENSIVE REVIEW OF MY BACKGROUND. I UNDERSTAND THIS MAY INCLUDE EMPLOYMENT HISTORY, EDUCATION BACKGROUND, CHARACTER REFERENCES, DRUG TESTING, CIVIL AND CRIMINAL PUBLIC RECORDS. I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me to Intercept of Florida or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Intercept of Florida and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including but not limited to, address, social security numbers, and dates of birth. Intercept of Florida is an Equal Opportunity Employer. We are committed to equal treatment of all employees without regard to race, national origin, religion, gender, age, sexual orientation, veteran status, physical or mental disability or other basis protected by law.