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Your Information

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Use your resume or LinkedIn Profile to fill in many of the fields on this application form.

Personal Information

How did you hear about us?

If you have selected Employee Referral, please insert Employee name and location.

Additional Information

Have you ever filed an application with us before?

Have you ever been employed with D4C Dental Brands, Inc. or any of its affiliates previously?

Are you subject to any non-competition or non-solicitation obligations or other restrictions of any kind that could in any way limit or otherwise affect your ability to be employed by D4C Dental Brands or to provide services to or on behalf of D4C Dental Brands?

Are you currently eligible to work in the U.S., and authorized to work for this company on an ongoing indefinite basis?

Can you travel if a job requires it?

Do you have any relationship with an employment agency or other restrictions on your ability to be hired without D4C Dental Brands paying a fee?

Do you have any friends or relatives employed at D4C Dental Brands or any of its affiliates or divisions?

CRIMINAL BACKGROUND INFORMATION


**A Note About Various State Laws**
State law applies to you as an applicant if: (a) you are applying to a D4C Dental Brands location within that state OR (b) you are currently residing within that state. If you are currently residing in or applying for jobs in HI; MA; MD; and MN; the below question should not be answered with a “yes” or “no” but instead with “I currently reside in or am applying for job positions in HI; MA; MD; and MN and therefore am not required to answer the question on this application and for that reason am checking this box.”
CA applicants: Applicants are not required to disclose misdemeanor convictions involving marijuana or controlled substances as described in CA Labor Code § 432.8 that are more than two years old, and misdemeanor convictions for which probation has been successfully completed or discharged and that have been judicially dismissed.
CT applicants: Applicants are not required to disclose any conviction that has been erased pursuant to § 46(b)-146, 54-76(o) or 54-142(a) of the CT General Statute. Criminal records subject to erasure are records pertaining to a finding of delinquency or that a child
was a member of a family with service needs, an adjudication as a youthful offender, a criminal charge for which the person has been found not guilty, or a conviction for which the person received an absolute pardon. Any person whose criminal records have been erased shall be deemed to have never been arrested within the meaning of the general statutes with respect to the proceedings so erased and may so swear under oath.
GA applicants: Applicants may exclude convictions discharged under Georgia’s First Offender Programs.
MA applicants: Under Massachusetts law, an employer is prohibited from making written, pre-employment inquiries of an applicant about his or her criminal history. Massachusetts applicants should not respond to any question seeking criminal record
information.
After the application stage, applicants may omit from disclosing a first conviction for drunkenness, simple assault, speeding, affray, minor traffic violations, or disturbances of the peace. Applicants are also only required to disclose misdemeanor
convictions occurring within five (5) years preceding the date of this application.
NV applicants: Applicants are not required to disclose misdemeanor convictions older than 10 years.
NY applicants: Applicants for job positions may exclude an adjudication as a youthful offender.
OH applicants: Applicants with a conviction for a minor misdemeanor violation involving marijuana does not constitute a criminal record and does not need to be reported by the person so convicted in responding to the questions on this application.
WA applicants: Applicants are not required to disclose felony or misdemeanor convictions older than 10 years.
MD (Montgomery County) applicants: Employer is prohibited from asking about or seeking out the criminal history of an applicant before the conclusion of the first interview. Employer is prohibited from inquiring about any (1) arrest or accusation of crime or (2)
criminal conviction.
Do not disclose the existence of any conviction which has been annulled, erased, sealed, expunged, or otherwise eradicated by state or court order. A criminal conviction is not an automatic or absolute bar to employment, and while
convictions will be considered based on the time and nature of the offense and as related to jobs applied for, applicants should answer the following question.  An applicant that resides in or is applying for positions in the states that prohibit employers from asking the criminal question on the application will not be adversely impacted by checking the third box below in response to the criminal background question.

If YES, please describe the circumstances of your conviction, including the date, nature, place of the offense, and disposition of the
case.

 

Please list any foreign languages you can speak read and/or write

Resume and Questions

Upload Your Resume

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Resume Text

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Additional Attachments

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Work and Education History

Employment History

If no work history, please type N/A for all required fields

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Education History

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Other History

Certificates and Licenses

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Work Related References

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Review and Submit

I understand and agree that:
1. The information I have provided on this Application is true and complete to the best of my knowledge and is subject to verification by the Company. Any misrepresentation or omission of any fact in my Application, resume, or any other materials, or during any interview, can be justification of refusal for employment or, if employed, grounds for discipline, up to and including immediate discharge.


2. I understand that if hired, unless I am employed under a specific written contract or collective bargaining agreement, my employment with the Company will be “at-will” and that my employment may be terminated at any time with or without cause and with or without notice. I further understand that I may terminate my employment with or without cause and with or without notice at any time. I further understand that the completion of an application with the Company is a preliminary step to employment. It does not obligate the Company to offer employment to me, or for me to accept employment.


3. Any offer of employment I may receive from the Company is contingent upon my successful completion of the Company’s total pre-employment screening process, including the Company’s receiving references it considers satisfactory. I further understand that any offer of employment is subject to my providing proof of work eligibility, as required by United States law.


4. In processing my Application for Employment, the Company may verify all the information provided by me, or may procure or have prepared a consumer or investigative consumer report for this purpose concerning my prior employment, military record, educational background, credit, criminal, and motor vehicle records, as well as character and general reputation as allowed by applicable law. Where applicable, the Company may also verify any professional license that I may hold as well. The Company will obtain necessary authorizations prior to conducting such background checks.


5. I authorize any of the persons or organizations referenced in this Application to give the Company any and all information concerning my previous employment, including a statement of the reasons for the termination of my employment, work performance, abilities and other qualities pertinent to my qualifications for employment, education and any other information they might have, personal or otherwise, with regard to any of the subjects covered by the Application. I release all such parties from all liability from any damages which may result in furnishing such information to the Company.


6. I acknowledge that no other representations concerning the term or nature of my employment have been made to or relied on by me. In consideration of my employment, I agree to comply with the policies, procedures, rules, and regulations of the Company, and I understand that if hired my employment and compensation can be terminated with or without cause or notice, at any time at the option of either the Company or myself.


FOR MARYLAND APPLICANTS: UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.


FOR MASSACHUSETTS APPLICANTS: IT IS UNLAWFUL IN MASSACHUSETTS TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND CIVIL LIABILITY.


D4C DENTAL BRANDS DOES NOT USE LIE DETECTOR TESTS AS PART OF THE APPLICATION PROCESS.

Candidate Sign Off

I certify that all of the information in this application is true and correct as of this date.

Application Review