Outpost Job Application
Name
First Name
Last Name
Date of Birth
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Available to Work:
Full-Time
Part-Time
Seasonal
What’s your current availability? (Check all that apply)
I can work day shift hours
I can work evening shift hours
I can work weekdays
I can work weekends
I can work weekday evenings and anytime on weekends
If someone referred you to us, please list the name of person.
Are you legally authorized to work in the United States?
Yes
No
Are you currently employed?
Yes
No
Have you ever been discharged from any employment or asked to resign?
Yes
No
If yes, provide date and a short explanation:
If you have ever worked under another name, please provide it here:
Have you ever been convicted of a felony within the last five years? (Note: A conviction record is not an automatic bar to employment. A conviction will be considered only in relation to specific job requirements. An applicant shall be notified if an adverse decision was based on conviction data.)
Yes
No
If yes, please describe:
Employment History
List the most recent first please.
Employer 1:
Phone:
Address
Duties/Responsibilities:
Supervisor's Name/Title
What dates did you work at this place of employment?
Reason for leaving:
Employer :2
Phone:
Address
Duties/Responsibilities::
Supervisor's Name/Title
What dates did you work at this place of employment?
Reason for leaving:
EDUCATION
(NOTE: Applicants may be required to provide proof of diploma, degree, transcripts, licenses, certifications, & registrations.)
High School (Please list name and location of school, dates attended, graduation or expected graduation date.)
Undergraduate College or University (Please list name and location of school, dates attended, graduation or expected graduation date, type of diploma/degree received, and Major/Minor fields of study.)
Technical, Vocational, or Business Schools (Please list name and location of school, dates attended, graduation or expected graduation date, type of diploma/degree received, and Major/Minor fields of study.)
List 3 Professional References: (Please provide name of person, company name, title, phone number and years acquainted. Must be managers, peers, or supervisors whom you have known at least one year.)
NOTIFICATION AND AGREEMENT
1. I understand that The Company will consider any requests for accommodations of physical or mental disabilities by an otherwise qualified person at any time before or after employment begins. I understand that the company would appreciate as much advance notice as possible regarding request for accommodation, and that documentation of the need for accommodation might be required. 2. I understand that a background check may be performed as a condition of employment. I authorize The Company and/or its agents to thoroughly request, receive and verify all statements and information contained in my application and resume. I release The Company from all liability for any damages that may result from doing so. I authorize any persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application. I release all such parties from all liability for any damages that may result from furnishing such information to The Company. 3. I certify that the information provided by me in this application (and accompanying resume, if any) is true and complete. I understand that any misstatement, falsification, omission or misrepresentation on this application or in any interview is grounds for refusal to hire, or if I am hired and the same is discovered thereafter, I will be separated. I understand that all information provided by me on this application or in any interview is subject to verification. 4. I acknowledge that if I am employed by The Company, my employment will be at-will, that I will be required to follow all rules and regulations of the company and that my employment may be terminated with or without cause, with or without notice at the option of myself or the company. No one other than the President has the authority to enter into any agreement for employment for any specified period of time or to make an agreement contrary to foregoing, either before commencement of employment or after I have become employed. 5. I certify that I have read or have had read to me, items 1, 2, 3 and 4 above. I understand the contents and hereby acknowledge receipt of this information.
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