Billing Specialist Employment Application

  • Personal Information

  • If hired, can you provide proof of U.S. Citizenship or proof of your legal right to live and work in the United States of America
  • Do you have a valid California Drivers License?
  • Are you currently employed?
  • Education, Training, and Experience

  • Please include the city and state.
  • Please include the city and state.
  • Please include the city and state.
  • Certifications

  • Do you have any other experience, training, qualifications or skills, which you feel make you especially suited for work at Sequoia Safety Council? If so, explain.
  • Employment History

    List below all past and present employment starting with your most recent employer (last 10 years). Account for all periods of unemployment.
  • Please include both the start and end dates of this employment.
  • Please include both the start and end dates of this employment.
  • Please include both the start and end dates of this employment.
  • Please include both the start and end dates of this employment.
  • Military Service

  • If you've obtained any specialized skills or abilities as the result of military service, please explain here.
  • References

    List below three (3) persons not related to you who have knowledge of your work performance within the last three years. Please do not include any previous listed supervisors.
  • This field is for validation purposes and should be left unchanged.
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