APPLICATION FOR EMPLOYMENT
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
We consider applicants for all positions without regard to race, religion, creed, gender, national origin, color, age,
disability, marital or veteran status, sexual orientation, or any legally protected category.
Required fields are marked with an asterisk (*).
|
|
|
|
|
|
How did you learn about us?
|
|
|
|
|
Present Address:
|
Permanent Address:
|
|
|
|
|
|
|
|
|
|
|
|
|
If you are under 18 years of age, can you provide required proof of your eligibility to work?
|
|
Have you ever filed an application with us before? If yes, provide date (month/date/year):
|
|
|
|
Have you ever been employed by us before? If yes, provide date (month/date/year):
|
|
|
|
Do you have any relatives employed by us? If yes, provide name(s):
|
|
Relative #1:
|
Relative #2:
|
|
|
|
|
Are you currently employed?
|
|
May we contact your current employer?
|
|
Are you legally eligible for employment in the United States?
|
|
On what date will you be available to begin work? Provide date (month/date/year):
|
|
Are you available to work (Check all that apply):
|
|
Are you currently on "lay off" status and subject to call back?
|
|
Are you willing to travel?
|
|
Are you available for over-night travel if required?
|
|
Have you ever plead guilty or been convicted of a crime, other than minor traffic violation, or
do you have any reprimands/censures/investigations past or present on your professional license?
(Record of conviction does not automatically disqualify you from employment consideration)
|
|
|
Please provide the following information:
|
|
|
|
|
|
|
EDUCATION
|
High School
|
|
|
|
|
|
|
Undergraduate College
|
|
|
|
|
|
|
Graduate/Professional
|
|
|
|
|
|
|
Other (specify)
|
|
|
|
|
|
|
Indicate any foreign languages you can speak, read and/or write. (give description)
|
|
Fluent |
Good |
Fair |
Speak |
|
|
|
Read |
|
|
|
Write |
|
|
|
|
|
|
|
|
|
|
EMPLOYMENT EXPERIENCE
Start with your present or last employer. Include any job related military service/assignments and volunteer activities. You may
exclude organizations which indicate race, color, religion, gender, national origin, disabilities or protected status. Please complete
section fully and do not write “see resume.”
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dates of Employment (month/day/year):
|
Dates of Employment (month/day/year):
|
Hourly/Salary:
|
Hourly/Salary:
|
|
|
|
|
|
|
|
|
May we contact this employer:
|
May we contact this employer:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dates of Employment (month/day/year):
|
Dates of Employment (month/day/year):
|
Hourly/Salary:
|
Hourly/Salary:
|
|
|
|
|
|
|
|
|
May we contact this employer:
|
May we contact this employer:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dates of Employment (month/day/year):
|
Dates of Employment (month/day/year):
|
Hourly/Salary:
|
Hourly/Salary:
|
|
|
|
|
|
|
|
|
May we contact this employer:
|
May we contact this employer:
|
|
|
ADDITIONAL INFORMATION
|
|
Skills List and/or Equipment Operated:
|
Check all that apply:
|
|
|
|
|
|
|
|
Note to applicants: DO NOT ANSWER THE FOLLOWING QUESTION UNLESS YOU HAVE BEEN
INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Are you capable of performing, with or without reasonable accommodations, the essential activities and functions of
the position for which you have applied?
|
|
|
PROFESSIONAL REFERENCES
|
Reference 1
|
Reference 2
|
|
|
|
|
|
|
|
|
Reference 3
|
|
|
|
|
|
|
|
|
|
APPLICANT’S STATEMENT
|
I certify the answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application foe employment as may be
necessary in arriving at an employment decision. I hereby release employers, schools, or persons from all
liability in responding to inquiries in connection with my application.
This application for employment shall be considered active for the period of time not to exceed 90 days.
Any applicant wishing to be considered for employment beyond this time period should inquire as to
whether or not applications are being accepted.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment
relationship with this organization is of an at will nature, which means that the employee may resign at
any time and the employer may discharge employee at any time with or without cause. It is further
understood that this at will employment relationship may not be changed by any written document or by
conduct unless such change is specifically acknowledged in writing by an authorized executive of this
organization.
In the event of employment, I understand that false or misleading information given in my application,
resume or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules
and regulations of the employer. I recognize as a condition of further employment, I must submit to a
drug screen where the results will be used to determine my eligibility for additional employment with this
organization.
|
|
|
Submit
|