JOB APPLICATION

JOB APPLICATION
Nested Beads of Path

1373 Lees Chapel Rd Apt 106-A, Greensboro, North Carolina 27455 (336)419-5217
Nested Beads Of Path is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need a reasonable accommodation in the application process, he, she, they, them and preferred name should contact a company representative.

Please fill out all of the sections below:
Applicant Information
Applicant Name/Preferred Name:
Address:
City, State and Zip Code:
Telephone Number:
Email Address:
example@example.com
Date of Application:

Month Day Year
Date
Employment Position
Position(s) applying for: (fulltime/partime)
How did you hear about this position?
What days are you available for work?
What hours or shift are you available for work?
If needed, are you available to work overtime?
On what date can you start working if you are hired?

Month Day Year
Date
Do you have reliable transportation to and from work?
Salary desired:
Personal Information
Have you ever applied to or worked for Nested Beads of Path before?
No
Do you have any friends, relatives, or acquaintances working for Nested Beads of Path Yes
Yes
If yes, state name & relationship:
Are you 18 years of age or older? Are you a U.S. citizen or approved to work in the United States?
What document can you provide as proof of citizenship or legal status?
Will you consent to a mandatory controlled substance test?
No
Do you have any condition which would require job accommodations?
Yes
If yes, please describe accommodations required below.
Have you ever been convicted of a criminal offense (felony or misdemeanor)? If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:
If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:
Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying:
(Note: Nested Beads of Path complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional. )
Education and Training
High School
Year Graduated
College/University
Location (City, State)
Degree Earned
Vocational School/Specialized Training
Name
Military:
Are you a member of the Armed Services?
What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
What military skills do you possess that would be an asset for this position?
Previous Employment
Job Title: Supervisor Name: Employer Address: City, State and Zip Code: Employer Telephone: Dates Employed: Reason for leaving:
Employer Name:
Job Title:
Supervisor Name: Employer Address:
City, State and Zip Code:
Employer Telephone: Dates Employed:
Reason for leaving:
Employer Name:
Employer Name:
Supervisor Name:
Employer Address:
Employer Telephone:
Dates Employed:

Month Day Year
Date
References
Please provide 3 personal and professional reference(s) below:
Reference
Contact Information
AT-WILL EMPLOYMENT
The relationship between you and the Nested Beads of Path is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Nested Beads of Path . No representative of Nested Beads of Path has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written
statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.
Applicant Signature:

Clear
Dated:

Month Day Year
Date
Should be Empty:

JOB APPLICATION

Nested Beads of Path

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

High School

College/University

Vocational School/Specialized Training

Military:

Previous Employment

Employer Name:

Employer Name:

References

Reference

Contact Information

AT-WILL EMPLOYMENT