Leavitt Funeral Home Application

Thank you for your interest in employment with Leavitt Funeral Services and Crematory. Please complete the application below and tap the submit button for your application to be securely received by our personnel office. We will be in touch with you within a week of your submission.
Personal Overview
Name:*

First NameLast Name
Phone Number:*
Email Address:*
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Level of education achieved:*

High School/GEDCollege/UniversityBusiness/TechnicalOther/Additional
Other/additional:
I am legally eligible for employment in the U.S.:*

YesNo
Are you a Veteran?*

YesNo
Career Interests
I am seeking the following type of position:*

Permanent PositionPart-time PositionStudent InternshipPost-College Apprenticeship
If needed, I am able to work overtime:*

YesNo
If needed for the job, I can provide a valid Drivers License:*

YesNo
I am available to work the following shifts:*

DayNightFlexible
How were you referred to us?

Walk-InEmployeeNewspaper AdSocial MediaCareer FairOnline AdOther (please specify)Radio/TV
Other:
Job Skills & Training
Describe your skills:*

0/200
Training or Certifications if any:

0/200
References
Please list up to two (2) references that are familiar with your work life.
Reference 1
Name:*

First NameLast Name
Phone Number:*
Email Address*
example@example.com
How do you know this reference?
Years known:*
Reference 2
Name:

First NameLast Name
Phone Number:
Email Address:
example@example.com
How do you know this reference?
Years Known:
Upload Resume (optional):

Upload a File

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Disclaimer and Signature (Read and sign in the box below.)
I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired. I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for employment. I also authorize you to request and receive such information. In consideration for my employment, I agree to abide by the rules and regulations of Leavitt Funeral Home, which rules may be changed, withdrawn, added or interpreted at any time, at Leavitt's sole option and without prior notice to me. I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the company or myself. *

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Date*

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Date
Please verify that you are human*
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