EMPLOYMENT APPLICATION (Florida, Ft. Pierce)

BACKGROUND
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR A FIRST DEGREE MISDEMEANOR?*

YesNo
If "YES", what charges?
Where Convicted?
Date of Conviction

MonthDayYear
Date
HAVE YOU EVER PLED NOLO CONTENDERE OR PLED GUILTY TO A CRIME WHICH IS A FELONY OR A FIRST DEGREE MISDEMEANOR?*

YesNo
If "YES", what charges?
Where?
Date

MonthDayYear
Date
HAVE YOU EVER HAD THE ADJUDICATION OF GUILT WITHHELD FOR A CRIME WHICH IS A FELONY OR A FIRST DEGREE MISDEMEANOR?*

YesNo
If "YES", what charges?
Where?
Date

MonthDayYear
Date
NOTE: A "YES" answer to these questions will not automatically bar you from employment. The nature, job-relatedness, severity and date of the offense in relation to the position for which you are applying are considered.
CITIZENSHIP
Southern Eagle Distributing hires only U.S. citizens and lawfully authorized alien workers. If a conditional offer of employment is made, you will be required to provide identification and proof of citizenship or authorization to work in the U.S.
ARE YOU A U.S. CITIZEN OR ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S.?*

YesNo

EDUCATION
Highest Level of Education*
1. Name of School*
City*
State*
Phone Number
(FROM)

MonthDayYear
Date
(TO)

MonthDayYear
Date
Did you graduate?

YesNo
Degree
2. Name of School
City
State
Phone Number
(FROM)
(TO)
Did you graduate?

YesNo
Degree
3. Name of School
City
State
Phone Number
(FROM)
(TO)
Did you graduate?

YesNo
Degree

List any occupational/professional licenses, specialized training you have for the position you are applying for.
In a brief statement, in your own words , please describe why you are an ideal candidate for this position*
In a brief statement, please describe your short and long term career goals.*
MILITARY SERVICE
Start Date
End Date
Branch
Highest Rank Attained
Duties

PRE-EMPLOYMENT STATEMENT (Please read before signing) I understand that the organization will rely, in part, on the information I provide in this Employment Application in considering whether to hire me. I understand that it is important that I provide complete and accurate information and certify that I have done so. If the organization discovers at any time that I failed to completely and honestly provide any information requested of me in this Employment Application or during the interview process, I understand that my application will no longer be considered or, if I am working for the organization, that I will be subject to disciplinary action, up to and including termination of employment. The organization is committed to compliance with the provisions of this nation’s immigration laws regarding verification of employment eligibility. Any offer of employment will be contingent upon your ability to provide legally sufficient documentation showing your eligibility to be employed by this organization. Applicants or employees that present fraudulent documents for employment verification purposes will be terminated. I authorize the organization to contact anyone that it deems appropriate to verify the information I have provided or to further investigate my background, past performance and suitability for employment. I consent to being discussed by any person contacted by the organization and waive all rights to bring any action for defamation, invasion of privacy or any similar claim against anyone that provides information to the organization with a good faith belief that the information provided is true. I understand that the organization may choose to obtain background information about me from a consumer reporting agency. Before requesting a report from a consumer reporting agency, the organization will ask for my authorization. I understand that if I refuse to provide such authorization, my application for employment will not be considered. I understand that this Employment Application is not an offer of employment. I understand that nothing contained in this Employment Application creates a contract between the organization and me for employment or any other benefit. No promises regarding employment have been made and I understand that no such promise or guarantee is binding upon the organization. I understand that if I am hired, I will be an employee "at will," meaning I am not hired for any definite length of time and either I or the organization can terminate my employment at any time for any or no reason. If employed, I understand and agree that the organization retains the sole right in its business judgment to modify, suspend, interpret, or cancel, in whole or in part, at any time, with or without any notice, any published or unpublished policy, practice, procedure, process, or benefit. If employed, that Southern Eagle Distributing is a Drug Free Workplace and as such will submit myself at the employers discretion, to an examination to detect the presence of controlled substances in my system. I understand that I will be required to comply with federal and/or state Drug Free Workplace Laws and regulations. I understand and agree to comply with such laws. If employed, I understand that as a condition of employment that I may be required to agree to and sign the organization"s confidentiality, non-compete, and/or other similar agreements. I also agree to notify the organization during the pre-employment process of any confidentiality, non-compete, and/or other similar agreements that I may have already signed with current and/or former employers.
EMPLOYEE NOTICES
PLEASE READ CAREFULLY NOTICE TO JOB APPLICANT AND JOB APPLICANT ACKNOWLEDGEMENT OF BINDING ARBITRATION I agree that I will settle any and all previously un-asserted claims, disputes or controversies arising out of, relating to, or in connection with, my application or candidacy for employment and/or cessation of employment with Southern Eagle Distributing, exclusively by final and binding arbitration before a neutral arbitrator. By way of example only, such claims include claims under federal, state, and local statutory or common law, such as the Age Discrimination in Employment Act, Title VII of the Civil Rights Act of 1964, as amended, including the amendments of the Civil Right Act of 1991, the Americans with Disabilities Act, the law of contract and the law of tort.
By checking the box below you are applying your signature and you agree to this Applicant Statement.*

I ACCEPT
By typing your name below, you hereby affirm your intent to sign this application as if you have placed your written signature. Furthermore, you hereby affirm that the information you have provided in this application is true, accurate and complete, and your intent to be bound by such information. False, misleading or incomplete information will lead to denial of your application or termination of employment if discovered subsequent to hiring.
Signature*
Date

MonthDayYear
Date
.
Please verify that you are human*
.
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