Application For Employment
Sierra Concepts LLC is an equal opportunity employer and does not discriminate on the basis of race, national origin, religion, age, sex, handicap or disability or other basis prohibited by applicable local, state or federal fair employment laws or regulations. Applications will only be accepted when there is an open and listed job vacancy. Applications will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, you must re-apply if you wish to continue to be considered for employment. Applicants with a disability may request accommodations needed in the application and/or interview process.
Fields marked with asterisk (*) are required
Personal Information
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is the best time to contact you?
*
Please Select
Morning
Lunch Time
Evening
Afternoon
Doesn't Matter
What position are you applying for?
*
What is your available start date?
*
-
Month
-
Day
Year
Date
What is your desired pay?
*
Hourly
Are you currently a citizen of the United States?
*
Yes
No
If you are not a citizen, are you authorized to work in the United States?
Yes
No
Have you ever worked for this Sierra Concepts?
*
Yes
No
If you have worked for Sierra Concepts, please detail when:
Have you been Convicted of a felony?
*
Yes
No
If you have been convicted of a felony, please explain:
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Application For Employment
Sierra Concepts LLC is an equal opportunity employer and does not discriminate on the basis of race, national origin, religion, age, sex, handicap or disability or other basis prohibited by applicable local, state or federal fair employment laws or regulations. Applications will only be accepted when there is an open and listed job vacancy. Applications will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, you must re-apply if you wish to continue to be considered for employment. Applicants with a disability may request accommodations needed in the application and/or interview process.
Education
High School
*
High School Attended
Street Address
City
State
Zip Code
Did you graduate High School?
*
Yes
No
College
College Attended
Street Address
City
State
Zip Code
Did you graduate College?
Yes
No
Describe any other training you consider relevant to the position you are applying:
List any other skills you have or equipment you can operate:
Can you perform the essential function of the position for which you are applying?
*
Yes
No
Do you have a valid Wisconsin Drivers License?
*
Yes
No
Please supply Valid Drivers license number:
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Application For Employment
Sierra Concepts LLC is an equal opportunity employer and does not discriminate on the basis of race, national origin, religion, age, sex, handicap or disability or other basis prohibited by applicable local, state or federal fair employment laws or regulations. Applications will only be accepted when there is an open and listed job vacancy. Applications will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, you must re-apply if you wish to continue to be considered for employment. Applicants with a disability may request accommodations needed in the application and/or interview process.
References
Please list three professional references
Name
First Name
Last Name
Company
Relationship
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
First Name
Last Name
Company
Relationship
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
First Name
Last Name
Company
Relationship
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Application For Employment
Sierra Concepts LLC is an equal opportunity employer and does not discriminate on the basis of race, national origin, religion, age, sex, handicap or disability or other basis prohibited by applicable local, state or federal fair employment laws or regulations. Applications will only be accepted when there is an open and listed job vacancy. Applications will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, you must re-apply if you wish to continue to be considered for employment. Applicants with a disability may request accommodations needed in the application and/or interview process.
Previous Employment
Start with the most recent job. Include self-employment and Military service. for part-time work, show the average number of hours per month. Show any changes in job title for the same employer as a separate position. Attach additional sheets if necessary.
Company
*
Phone Number
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor
*
Job Title
*
Starting Salary?
*
Hourly
Ending Salary?
*
Hourly
Employment start date?
*
-
Month
-
Day
Year
Date
Employment end date?
*
-
Month
-
Day
Year
Date
Responsibilities
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
Company
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor
Job Title
Starting Salary?
Hourly
Ending Salary?
Hourly
Employment start date?
-
Month
-
Day
Year
Date
Employment end date?
-
Month
-
Day
Year
Date
Responsibilities
May we contact your previous supervisor for a reference?
Yes
No
Company
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor
Job Title
Starting Salary?
Hourly
Ending Salary?
Hourly
Employment start date?
-
Month
-
Day
Year
Date
Employment end date?
-
Month
-
Day
Year
Date
Responsibilities
May we contact your previous supervisor for a reference?
Yes
No
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Application For Employment
Sierra Concepts LLC is an equal opportunity employer and does not discriminate on the basis of race, national origin, religion, age, sex, handicap or disability or other basis prohibited by applicable local, state or federal fair employment laws or regulations. Applications will only be accepted when there is an open and listed job vacancy. Applications will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, you must re-apply if you wish to continue to be considered for employment. Applicants with a disability may request accommodations needed in the application and/or interview process.
Sierra Concepts Employee Referral
Were you referred by a Sierra Concepts employee?
Yes
No
Employee who referred you
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Voluntary Self Identification
The Equal Employment Opportunity Commission (EEOC) requires organizations with 100 or more employees to invite applicants to self-identify gender, race, and complete a EEO-1 report each year. Completion of this data is voluntary and will not affect your opportunity for employment, or terms and conditions. This form will be used for EEO-1 reporting only and will be kept separate from all other personal records only accessed by the Human Resource Department. Please return completed forms to the HR department.
Name
I choose to not self-identify
Yes
Do you need assistance in the hiring process
Yes
No
What type of assistance will you need
Sex
Male
Female
Race / Ethnicity
Hispanic or Latino
White
Black or African American
Native Hawaiian or Other Pacific Islander
Veteran Status
Non Veteran
Veteran (DD214 form attached)
Veteran claiming disability (DD214 form and Veterans Disability form attached)
Other
Date Completed
-
Month
-
Day
Year
Date
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Application For Employment
Sierra Concepts LLC is an equal opportunity employer and does not discriminate on the basis of race, national origin, religion, age, sex, handicap or disability or other basis prohibited by applicable local, state or federal fair employment laws or regulations. Applications will only be accepted when there is an open and listed job vacancy. Applications will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, you must re-apply if you wish to continue to be considered for employment. Applicants with a disability may request accommodations needed in the application and/or interview process.
Authorization, Release, and Certification
I certify that all information on this application is true, complete, and correct to the best of my knowledge. I understand that any false or misleading statements by me, or material omission of information requested of me, may result in rejection of my application or, if employed, may immediate dismissal
*
Yes
I hereby give permission to the employer to seek to verify and supplement the information set forth in the application. I release from all liability or legal claims every person seeking or providing information, whether oral or written. A photocopy of this release shall be as valid as the original, and my be relied upon by all persons providing information.
*
Yes
I understand that employment with this employer is not contractual and is at will. I understand and agree that, if hired, I may voluntarily leave employment at any time, and may be terminated at any time, without notice for any reason. I understand that any oral or written statements which I may claim to have been made to me now or in the future inconsistent with the provisions of this paragraph are expressly disavowed and revoked by the company, and should not be relied upon by me as an applicant for employment or as an employee, if hired.
*
Yes
I understand that this application will be considered inactive after thirty days.
*
Yes
I certify I have read (or have had read to me) and understand this authorization, release, and certification.
*
Yes
Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Should be Empty: