Careers

Please complete ALL fields marked with *

Personal INFORMATION

E.g. 555-123-1234

E.g. 555-123-1234

Are you younger than 18 years old? *
If Yes, do you have a work permit?

E.g. MM/DD/YYYY

Availability

What schedule can you work?

What is the earliest that you can go into work and what is the latest you can stay?

Overall Availability *

Employment Information

Do you have a reliable means of transportation to work? *
Are you presently employed? *

If Yes, complete Current Employer section.

Current Employer

E.g. Street Address, City, ST Zip

E.g. MM/DD/YYYY

2) If hired can you provide verification of your legal right to work in the US? *
3) Have you ever been dismissed, or asked to resign from any position? *
4) Have you ever been convicted of a felony, or a misdemeanor? *

If Yes to #3 or #4, please explain:

A Yes answer to the above questions, does not necessarily disqualify an applicant from employment.

5) Are you willing to be subjected to a drug screening? *
6) Are you willing to be subjected to a background check? *

Education

High School

College

Trade/Business

Previous Employment History

History 1

E.g. MM/DD/YYYY

E.g. MM/DD/YYYY

History 2

E.g. MM/DD/YYYY

E.g. MM/DD/YYYY

History 3

E.g. MM/DD/YYYY

E.g. MM/DD/YYYY

References

Reference 1

E.g. Street Address, City, ST Zip

E.g. 555-123-1234

Reference 2

E.g. Street Address, City, ST Zip

E.g. 555-123-1234

Reference 3

E.g. Street Address, City, ST Zip

E.g. 555-123-1234

Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that my result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”

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