Application For Employment

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What type of employment are you seeking?
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Name
Present Address
Are you 18 years of age or older?
If hired, can you furnish proof you are eligible to work in the U.S.?

Have you ever applied here before?
Were you ever employed here?
Have you ever been convicted of any law violation?
Include any plea of "guilty" or "no contest". Exclude minor traffic violations.
A conviction will not necessarily disqualify an applicant for employment.
If employed, do you expect to be engaged in any additional business or employment outside of our job?
For Driving Jobs ONLY: Do you have a valid driver's license?
Have you had your driver's license suspended or revoked in the last 3 years?
Exclude labor organizations and memberships with reveal race, color, religion, national origin, sex, age, disability or other protected status.

Education History

Address of High School or GED

Address of College or University

Address of Vocational or Technical School

Employment History

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of employment. If self-employed, give firm name and supply business references. Note: A job offer be contingent upon acceptable references from current and former employees.

Employer 1

Address of Employer
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Name of Supervisor

Employer 2

Address of Employer
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Name of Supervisor

Employer 3

Address of Employer
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Name of Supervisor

Employer 4

Address of Employer
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Name of Supervisor

Have you ever worked or attended school under any other name?
Are you presently employed?
Have you ever been fired from a job or asked to resign?

Reference 1

Must not be relative or former employer.
Name
Address

Reference 2

Must not be relative or former employer.
Name
Address

Reference 3

Must not be relative or former employer.
Name
Address

Please read each statement carefully before signing

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I understand that I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required.

I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any of all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OF IMPLIED CONTRACT OF EMPLOYEMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.
Consent(Required)
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