EMPLOYMENT

College or University? Please list name, dates attended, and degree earned

What kind of employment are you seeking? *

Full-time

Part-time

Temporary

Have you ever been fired from a job or asked to resign? *

Yes

Do you have a valid driver's license? *

Yes

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SUBMITTING. 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. I authorize 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 consent 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 submission of this online application is a consent to these statements

Pay: Start $ and Final $ *

Are you presently employed? *

Yes

Job Title and Duties: *

What machines or equipment can you operate that relate to the job for which you are applying?

If yes, whom do you suggest we contact?

If employed, do you expect to be engaged in any additional business or employment outside of our job? *

Yes

Give three references, not relatives or former employers (Please provide name, address, and phone): *

EMPLOYMENT HISTORY. 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 supply business references. *

I acknowledge that a job offer may be contingent upon acceptable references from current and former employers

Pay: Start $ and Final $ *

Have you ever been convicted of any law violation? Include any plea of “guilty” or “no contest.” Exclude minor traffic violations. *

Yes

Vocational or Technical? Please list name, dates attended, and degree earned

Have you worked or attended school under any other names? *

If hired, can you furnish proof you are eligible to work in the U.S.? *

Yes

Job Title and Duties: *

Dates of Employment (Mo/Yr): *

Reason(s) for Leaving: *

When could you start work? *

Have you ever applied here before? *

Yes

Were you ever employed here? *

Yes

Driver's License Number, Class of License, State of Issuance:

Dates of Employment (Mo/Yr): *

Pay: Start $ and Final $ *

Reason(s) for Leaving: *

Dates of Employment (Mo/Yr): *

If yes, give details:

Are you 18 years of age or older? If you are hired, you may be required to submit proof of age *

Yes

What skills or additional training do you have that relate to the job for which you are applying?

List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability or other protected status.)

Job Title and Duties: *

Have you had your driver’s license suspended or revoked in the last 3 years? *

Reason(s) for Leaving: *

Last Name, First Name, Middle Name: *

If yes, please explain:

If yes, give details (A conviction will not necessarily disqualify an applicant for employment)

If yes, give details:

High School or GED? Please list name, dates attended, and degree earned