NFBA Employment Application Your Information Name * Phone * Alternate Phone Email Address * Additional Information Are you eligible to work in the United States? * Yes No Do you have relatives employed by the NFBA? * Yes No If Yes, provide name and relationship Have you ever been known by any other name * Yes No If Yes, please provide names Have you ever been convicted of a felony or first degree misdemeanor? * Yes No Have you ever been discharged or asked to resign from employment? * Yes No If Yes, explain fully each occasion of discharge or resignation. Do you have a valid drivers license? * Yes No How did you hear about this position? * Position Desired * Are you able to perform the essential functions of the position for which you are applying, with or without reasonable accomodation? (A description of the essential functions can be found on the job description.) * Yes No Upload Résumé (PDF or DOC formats) Upload Résumé Professional Licenses / Certifications Drivers License Number * State Issued * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Date Issued * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Drivers License Class * A B C E Knowledge / Skills / Abilities List your knowledge, skills, and abilities that you possess and believe to be relevant to the position you seek. BeginnerIntermediateAdvanced Microsoft Word Beginner Intermediate Advanced Microsoft Excel Beginner Intermediate Advanced Microsoft Outlook Beginner Intermediate Advanced Microsoft Access Beginner Intermediate Advanced Microsoft Powerpoint Beginner Intermediate Advanced Education & Training Do you have a high school diploma? * Yes No Do you have a GED? * Yes No College or University Name of School Location of School Major Number of Credits Received Degree Type - None -No Degree ReceivedAssociates DegreeBachelors DegreeGraduate Degree Additional College or University College or University Name of School Location of School Major Number of Credits Received Degree Type - None -No Degree ReceivedAssociates DegreeBachelors DegreeGraduate Degree Additional College or University College or University Name of School Location of School Major Number of Credits Received Degree Type - None -No Degree ReceivedAssociates DegreeBachelors DegreeGraduate Degree Describe any specialized training, apprenticeship, skills and extra-curricular activities. State any additional information you feel may be helpful to us in considering your application. Work History Please provide the following information for your current and previous employers. You may also list any volunteer experience you had that relates to the job for which you are applying. You must answer all questions for your application to be considered. Work Experience (Most Recent) Current or Previous Employer * Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Work Experience Previous Employer Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Work Experience Previous Employer Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Add More Work Experience Work Experience Previous Employer Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Veteran's Preference Would you like to claim veteran's preference * Yes No Active/Reserve Active Reserve Check the appropriate option. Documentation substantiating your claim must be furnished at the time of application. I.E., DD214, Certification of Service Related Disability, Evidence of Marriage, etc. 1. A veteran with a compensable service-connected disability or receiving compensation, disability retirement benefits or pension under public laws administered by the u.s. Veterans administration and the department of defense, or 2. The spouse of a veteran who cannot qualify for employment because of total and permanent service connected disability, or the spouse of a person missing in action, captured or forcibly detained by a foreign power, or 3. A veteran of the Persian gulf war beginning august 2,1990, who served at least one day during a wartime period, or 4. The unremarried widow or widower of a veteran who dies of a service connected disability. Branch of Service - None -Air ForceArmyCoast GuardMarine CorpsNavy Date Entered Service Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Discharged Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Note: under Florida law, preference in appointment and employment shall be given, by the state and its political subdivision, first to those persons in 1 and 2 above, and second to those persons included under 3 and 4 above. If any applicant claiming veteran’s preference for a vacant position is not selected for the position, they may file a complaint with the Florida department of veteran affairs, 11351 Ulmerton Road, Largo, FL 33778. The complaint must be filed within 21 calendar days of the applicant receiving notice of the hiring decision made by the employing agency or within three months of the date the application is filed with the employer, if no notice is given. Certification I hereby certify that all statements made in this application are true. I agree and understand that any misstatement, omission or falsification of facts shall cause forfeiture of all rights to employment with the NFBA. The NFBA is authorized to verify any or all information contained herein. I understand that employment with the NFBA will be conditioned upon a favorable pre-employment drug screen and background check. I understand that the use of narcotics and alcohol is strictly prohibited at the NFBA. I understand that if the NFBA has a reasonable suspicion to believe that i am under the influence of an alcoholic beverage, narcotics and/or non-prescribed drugs, or if i am involved in a serious accident, that I may be required to take a physical examination and/or drug screen test (blood or urinalysis) to be performed by a duly licensed medical doctor or facility. I also understand that refusal to take such a test will result in immediate suspension or discharge of my employment. I understand that this application may be subject to public inspection in accordance with the Florida public records law, Chapter 119, Florida statute. I certify I have read the above statement. The NFBA is an equal opportunity employer in compliance with laws prohibiting discrimination on the basis of race, color, sex, age, marital status, religion, national origin or disability.
NFBA Employment Application Your Information Name * Phone * Alternate Phone Email Address * Additional Information Are you eligible to work in the United States? * Yes No Do you have relatives employed by the NFBA? * Yes No If Yes, provide name and relationship Have you ever been known by any other name * Yes No If Yes, please provide names Have you ever been convicted of a felony or first degree misdemeanor? * Yes No Have you ever been discharged or asked to resign from employment? * Yes No If Yes, explain fully each occasion of discharge or resignation. Do you have a valid drivers license? * Yes No How did you hear about this position? * Position Desired * Are you able to perform the essential functions of the position for which you are applying, with or without reasonable accomodation? (A description of the essential functions can be found on the job description.) * Yes No Upload Résumé (PDF or DOC formats) Upload Résumé Professional Licenses / Certifications Drivers License Number * State Issued * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Date Issued * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Drivers License Class * A B C E Knowledge / Skills / Abilities List your knowledge, skills, and abilities that you possess and believe to be relevant to the position you seek. BeginnerIntermediateAdvanced Microsoft Word Beginner Intermediate Advanced Microsoft Excel Beginner Intermediate Advanced Microsoft Outlook Beginner Intermediate Advanced Microsoft Access Beginner Intermediate Advanced Microsoft Powerpoint Beginner Intermediate Advanced Education & Training Do you have a high school diploma? * Yes No Do you have a GED? * Yes No College or University Name of School Location of School Major Number of Credits Received Degree Type - None -No Degree ReceivedAssociates DegreeBachelors DegreeGraduate Degree Additional College or University College or University Name of School Location of School Major Number of Credits Received Degree Type - None -No Degree ReceivedAssociates DegreeBachelors DegreeGraduate Degree Additional College or University College or University Name of School Location of School Major Number of Credits Received Degree Type - None -No Degree ReceivedAssociates DegreeBachelors DegreeGraduate Degree Describe any specialized training, apprenticeship, skills and extra-curricular activities. State any additional information you feel may be helpful to us in considering your application. Work History Please provide the following information for your current and previous employers. You may also list any volunteer experience you had that relates to the job for which you are applying. You must answer all questions for your application to be considered. Work Experience (Most Recent) Current or Previous Employer * Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Work Experience Previous Employer Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Work Experience Previous Employer Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Add More Work Experience Work Experience Previous Employer Date Started Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Ended Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Job Address Job City Job State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Full Time or Part Time Full Time Part Time Annual Salary $ / year Reason for Leaving Veteran's Preference Would you like to claim veteran's preference * Yes No Active/Reserve Active Reserve Check the appropriate option. Documentation substantiating your claim must be furnished at the time of application. I.E., DD214, Certification of Service Related Disability, Evidence of Marriage, etc. 1. A veteran with a compensable service-connected disability or receiving compensation, disability retirement benefits or pension under public laws administered by the u.s. Veterans administration and the department of defense, or 2. The spouse of a veteran who cannot qualify for employment because of total and permanent service connected disability, or the spouse of a person missing in action, captured or forcibly detained by a foreign power, or 3. A veteran of the Persian gulf war beginning august 2,1990, who served at least one day during a wartime period, or 4. The unremarried widow or widower of a veteran who dies of a service connected disability. Branch of Service - None -Air ForceArmyCoast GuardMarine CorpsNavy Date Entered Service Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Date Discharged Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Note: under Florida law, preference in appointment and employment shall be given, by the state and its political subdivision, first to those persons in 1 and 2 above, and second to those persons included under 3 and 4 above. If any applicant claiming veteran’s preference for a vacant position is not selected for the position, they may file a complaint with the Florida department of veteran affairs, 11351 Ulmerton Road, Largo, FL 33778. The complaint must be filed within 21 calendar days of the applicant receiving notice of the hiring decision made by the employing agency or within three months of the date the application is filed with the employer, if no notice is given. Certification I hereby certify that all statements made in this application are true. I agree and understand that any misstatement, omission or falsification of facts shall cause forfeiture of all rights to employment with the NFBA. The NFBA is authorized to verify any or all information contained herein. I understand that employment with the NFBA will be conditioned upon a favorable pre-employment drug screen and background check. I understand that the use of narcotics and alcohol is strictly prohibited at the NFBA. I understand that if the NFBA has a reasonable suspicion to believe that i am under the influence of an alcoholic beverage, narcotics and/or non-prescribed drugs, or if i am involved in a serious accident, that I may be required to take a physical examination and/or drug screen test (blood or urinalysis) to be performed by a duly licensed medical doctor or facility. I also understand that refusal to take such a test will result in immediate suspension or discharge of my employment. I understand that this application may be subject to public inspection in accordance with the Florida public records law, Chapter 119, Florida statute. I certify I have read the above statement. The NFBA is an equal opportunity employer in compliance with laws prohibiting discrimination on the basis of race, color, sex, age, marital status, religion, national origin or disability.
