Employment Application Form

Please complete entire application - incomplete information could disqualify you from further consideration

Are there job openings that you are applying for?

First*

M.I.

Last Name*

Date

Street Address*

Apartment/Unit

City*

State*

Phone*

E-mail*

example@example.com

Date Available

Date

Desired Salary

Position Applied for

Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation(s)?

YesNo

Are you at least 18 years of age?

YesNo

Are you authorized to work in the U.S.?

YesNo

Can you work any shift?

YesNo

Can you work overtime, including weekends?

YesNo

Have you ever worked for this company?

YesNo

If So, when?

Have you ever been terminated or asked to resign by an employer?

YesNo

If so, provide details:

Do you know anyone who works for this company?

YesNo

If so, provide details:

How did you hear about us?

Walk InAdvertisementReferralOther

If you were referred to this company, who referred you?

High School

City/State

From

Date

To

Date

Did you graduate?

YesNo

College

City/State

From

Date

To

Date

Did you graduate?

YesNo

Degree?

Other Education

City/State

From

Date

To

Date

Did you graduate?

YesNo

Degree?

Full Name

Relationship

Company

Phone

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Full Name

Relationship

Company

Phone

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Full Name

Relationship

Company

Phone

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Company

Phone

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor

Job Title

From

Date

To

Date

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Company

Phone

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor

Job Title

From

Date

To

Date

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Company

Phone

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Supervisor

Job Title

From

Date

To

Date

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Please provide details:

Branch

From

Date

To

Date

Rank at Discharge

Type of Discharge

If other than honorable, explain

Solomon Colors, Inc. is an equal opportunity employer. Solomon Colors, Inc. does not discriminate in employment because race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Solomon Colors, Inc. to hire me. If I am hired, I understand that either Solomon Colors, Inc. or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Solomon Colors, Inc. has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Solomon Colors, Inc. true and complete information on this application. No requested information has been concealed. I authorize Solomon Colors, Inc. to contact references provided for employment reference checks. Ifany information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Signature

Date

THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE SIGNED/DATED ABOVE.

Attach Resume: (Multiple Files Allowed)

Employment Application

APPLICANT INFORMATION

EDUCATION

REFERENCE #1

REFERENCE #2

REFERENCE #3

PREVIOUS EMPLOYMENT

SKILLS

Military Service

Disclaimer and Signature