Employment Application

APPLICANT INSTRUCTIONS
If you need help filling out this application form or for any phase of the employment process, please contact us every effort will be made to accommodate your needs in a reasonable amount of time.

1. Please read "Applicant Note."
2. Complete all sections of the 2 page application form.
3. If more space is needed to complete any questions, use the back or additional paper.
4. Print clearly; incomplete or illegible applications will not be processed.

APPLICANT NOTE
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. All employee applications will be given active consideration for only sixty (60) calendar days and will receive consideration without discrimination of sex, marital status, race, age, creed, national origin or the presence of disabilities. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the applicant process or, if discovered after employment, terminating employment. A felony conviction will not necessarily bar an applicant from employment. Additional testing of job-related skills and for the presence of drugs in your body may be required prior to employment. After an offer of employment, and prior to reporting to work, you are required to submit to a medical review. Depending on company policy and the needs of the job, you will be required to complete a medical history form and may be required to be examined by a medical professional designated by the company.


BASIC INFORMATION

*Required


Check Position Option:

     

Are You A Minor?

     

If employed can you show proof of U.S. Citizenship?

     

Have you been convicted of a felony in the last ten (10) years?

     

If you are NOT a U.S. citizen, can you submit documents, after employment showing your legal right to work permanently in the United States?

     




EDUCATION


Please select the highest grade level completed


Graduate/Degree

     

Graduate/Degree

     

Graduate/Degree

     




EMPLOYMENT HISTORY

Since we make every effort to contact previous employers, the correct phone number is critical


MOST RECENT EMPLOYMENT

Are you currently working for this employer?

     

If yes, may we contact this employer?

     

Pay Per:

             

SECOND RECENT EMPLOYMENT

Are you currently working for this employer?

     

If yes, may we contact this employer?

     

Pay Per:

             

THIRD RECENT EMPLOYMENT

Are you currently working for this employer?

     

If yes, may we contact this employer?

     

Pay Per:

             




BUSINESS REFERENCES

Include only individuals familiar with your work ability. Do not include relatives.



CERTIFICATION AND RELEASE
I certify that I have read and understand the applicant note on page one of this form and that the answers given by me, the foregoing questions, and the statements made by me are true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentations of facts called for in this application may result in rejection of my applications or discharge at any time during my employment. I authorize the company, and/or its agents, including consumer reporting bureaus, to verify any of this information including but not limited to, criminal history and motor vehicle driving records. I authorize all persons, schools, companies, and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies, and law enforcement authorities from any liability for any damage whatsoever for issuing this information.

 

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