Employment Application - QuickFi® by Innovation Finance USA LLC

Applicant Information

Please enter your personal contact information.

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Job Information

Please enter information for the position that you are applying for at QuickFi.

Position Applied For*

Desired Salary*

Social Security Number*

Are you citizens of the United States?*

If no, are you authorized to work in the U.S.?

Have you ever been convicted of a felony?*

If yes, explain:

Education

Please enter your previous educational experience.

College 1*

Did you graduate?*

From:*

To:*

Diploma*

College 2

Did you graduate?

From:

To:

Diploma

Previous Employment

Please enter your previous employment experience.

Company 1*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title*

From:*

To:*

Supervisor*

Phone*

May We Contact Your Supervisor?*

Responsibilities*

Reason for Leaving*

Company 2

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title

From:

To:

Supervisor

Phone

May We Contact Your Supervisor?*

Responsibilities

Reason for Leaving

Certifications & Training

If applicable, please list any relevant certifications or training.

Certifications

Military Service

If applicable, please enter your previous military experience.

Branch

From:

To:

Rank at Discharge

Type of Discharge

If other than honorable, explain:

Disclaimer and Signature

Authorization*

I authorize Innovation Finance USA LLC and its agents to contact my current employer if necessary, to verify my current employment status.

I have carefully read and understand the FCRA Candidate Disclosure for the Procurement of Consumer Reports form, and if applicable, the California Candidate Disclosure for the Procurement of Investigative Consumer Reports form. I have also read and understand the attached Summary of Rights under the Fair Credit Reporting Act and State Law Disclosures. By my signature below, I authorize Innovation Finance USA LLC (“the Company”) to share the contents of this consumer report or investigative consumer report with its partners and clients in an effort to place me into an employment/independent contractor/volunteer relationship with those partners. The Company will only share the background report as necessary, and as authorized, in order to assign me to a client, partner company, or organization. I understand that if the Company hires or engages me, my consent will apply, and the Company may obtain reports throughout my employment/contract/tenure where state law allows. I also understand that the information contained in my job application or otherwise disclosed by me before or during my employment/contract/tenure, if any, may be used for the purpose of obtaining consumer reports and/or investigative consumer reports. By agreeing below, I authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency.

Consent*

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Date*

Innovation Finance USA LLC is committed to Equal Employment Opportunity and Affirmative Action and, as such, affirms in policy and practice to recruit, hire, train, and promote, in all job classifications, without regard to race, religion, color, national origin, citizenship, sex, age, veteran status, disability, genetic information, sexual orientation, gender identity or any other protected characteristic. Innovation Finance USA LLC will not discriminate against persons because of their disability and will make reasonable accommodations for known physical or mental limitations of qualified employees and applicants with disabilities. We will also make reasonable accommodations during the interview and selection process. Please contact our Human Resources Department in Fairport, NY for information.