Regal Job Application Form

Regal Job Application

Please complete the form below to apply for a position with us.
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
If under 18, can you provide a work permit?

YesNo
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
Have you ever worked for this company before?*

YesNo
If yes, when?

Are you legally allowed to work in the United States?*

YesNo
Have you ever been convicted of a crime?*

YesNo
If yes, please give dates and details.
Answering yes to these questions does not constitute an automatic rejection for employment. Date of offense, seriousness and nature of violation, rehabilitation, and position applied for will be considered.
Type of Employment Desired*
Position Desired
Driver's License Number
If applicable to position
Available Start Date*

MonthDayYear

Education History
Name & Location of High School
Did you graduate?
Name & Location of College
Years Attended
Degrees Completed
Other Subjects Studied
Trade, Business or Correspondence School
Years Attended
Do you have special skills or qualifications?

Previous Employment

Begin with most recent position.
Company Name
Position Held
Dates of Employment: Fromblanks To: blank .
City
State
Responsibilities
Starting Salary
Ending Salary
Reason for Leaving
May we contact this employer for a reference?

YesNo
Upload Your Resume

Cancelof
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they have, personal or otherwise, and release the company from all liability for any damages that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevent federal and state laws.
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