The Loft - Employment Application
All information obtained within this application will be held in strict confidence, subject to applicable law. We will not discriminate because of sex, age, race, physical disability, religion, ethnicity, marital status, ancestry, or place of origin.
Application Date
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Month
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Day
Year
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Full Name
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First Name
Last Name
Social Security Number
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Day Time Contact Phone
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Area Code
Phone Number
E-mail
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Date You Are Available For Employment
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Month
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Day
Year
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What Days Are You Available to Work?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How Many Hours Per Week Are You Interested In Working?
*
Please Select
1 Day (8 hours)
2 Days (up to 16 hours)
3 Days (up to 24 hours)
4 Days (up to 32 hours)
5 Days (up to 40 hours)
Are You Legally Entitled To Work In The United States?
*
YES
NO
Highest level of education completed:
*
Please Select
High School / GED
Some College
College Graduate
Do you have a valid driver's license?
*
YES
NO
Type of car you drive
*
License #
*
WORK HISTORY / EXPERIENCE
Please list your 3 most current work history/experience
Employer's Name (Most current)
Position Held
Supervisor's Name
Telephone
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Area Code
Phone Number
Reason for Departure
Duties
Start Date
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Month
-
Day
Year
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End Date
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Month
-
Day
Year
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May we contact this employer?
YES
NO
If NO, reason why not
(2) Employer's Name
Position Held
Supervisor's Name
Telephone
-
Area Code
Phone Number
Reason for Departure
Duties
Start Date
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Month
-
Day
Year
Date Picker Icon
End Date
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Month
-
Day
Year
Date Picker Icon
May we contact this employer?
YES
NO
If NO, reason why not
(3) Employer's Name
Position Held
Supervisor's Name
Telephone
-
Area Code
Phone Number
Reason for Departure
Duties
Full Name
First Name
Last Name
Start Date
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Month
-
Day
Year
Date Picker Icon
End Date
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Month
-
Day
Year
Date Picker Icon
May we contact this employer?
YES
NO
If NO, reason why not
Please provide 3 work related references.
REFERENCE 1
Full Name
First Name
Last Name
Relationship
E-mail
Phone Number
-
Area Code
Phone Number
REFERENCE 2
Full Name
First Name
Last Name
Relationship
E-mail
Phone Number
-
Area Code
Phone Number
REFERENCE 3
Full Name
First Name
Last Name
Relationship
E-mail
Phone Number
-
Area Code
Phone Number
False information given or implied on an application for is grounds for immediate dismissal without further notice.
I hereby state that all information provided is accurate and may be verified by you. I agree that I may be discharged if Estate Solutions of the Catawba Valley at anytime learns of falsification or material omission in the information provided on this application form and related documents. Estate Solutions of the Catawba Valley may contact my former employers. All references are hereby authorized to release all information which they may have relevant to my employment with them. I hereby release Estate Solutions of the Catawba Valley, its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references. I agree that I will follow all Estate Solutions of the Catawba Valley policies, rules, and procedures. I understand that Estate Solutions of the Catawba Valley reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at anytime. I agree to make myself available for random drug testing. I have never been convicted of a felony and I have no criminal charges pending against me. Estate Solutions of the Catawba Valley may acquire a criminal background check and drug testing prior to employment offer.
Any Other Information You Would Like To Share With Estate Solutions
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