APPLICATION FOR EMPLOYMENT
  • APPLICATION FOR EMPLOYMENT

    APPLICATION FOR EMPLOYMENT

  • We Are an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors. Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. Use blank paper if you do not have enough room on this application. PLEASE PRINT, except for signature on back of application. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

  • Todays Date*
     / /
  • What Type of Employment Are you Seeking?*
  • When could you start work?*
     - -
  • Date of Birth*
     / /
  • Format: (000) 000-0000.
  • Are you 18 years of age or older? (If you are hired, you may be required to submit proof of age*
  • Are you a Veteran?*
  • If hired, are you willing to submit a background check?*
  • If hired, can you provide proof you are eligible to work in the U.S.?*
  • Have you ever been convicted of any law violation? This includes any plea of "guilty" or "no contest." Exclude minor traffic violations?*
  • If employed, do you expect to be engaged in any additional business or employment outside of this job?*
  • Do you have a valid driver's license?*
  • Do you have means of transportation to and from work?*

  • Education

    LIST NAME AND ADDRESS OF SCHOOLS

    Number of Years Completed Diploma/Degree/Certificate Subjects Studied

  • Diploma / GED Received:*

  • College or University:

  • Diploma / GED Received:*
  • Certificate / Degree Received:*

  • Previous Employment

    List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and provide business references. Note: A job offer may be contingent upon acceptable references from current and former employers.

  • DATES OF EMPLOYMENT

  • START DATE OF EMPLOYMENT
     / /
  • END OR PRESENT DATE OF EMPLOYMENT
     / /
  • Format: (000) 000-0000.
  • Are you still employed?

  • DATES OF EMPLOYMENT

  • START DATE OF EMPLOYMENT
     / /
  • END OR PRESENT DATE OF EMPLOYMENT
     / /
  • Format: (000) 000-0000.
  • Are you still employed?

  • DATES OF EMPLOYMENT

  • START DATE OF EMPLOYMENT
     / /
  • END OR PRESENT DATE OF EMPLOYMENT
     / /
  • Format: (000) 000-0000.
  • Are you still employed?
  • Have you worked or attended school under any other names?*
  • Are you currently employed?*
  • Have you ever been fired from a job or ask to resign?*

  • Give three references, not relatives or former employers. 

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

    I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. Iauthorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. Iconsent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

    I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.

    I have read, understand, and by my signature, I consent to these statements.

  • Date*
     / /

  • This application for employment will remain active for a limited time. Ask the organization's representative for details.

  • Should be Empty: