Position(s) applied for:
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How did you learn about us? (Check all that apply) |
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Friend/relative |
Walk in |
Employment Agency |
Other |
If Other:
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If you are under 18 years of age, can you provide required proof of your
eligibility to work?
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Have you ever filed an application for employment with us before?*
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If you answered YES, When?
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Have you ever been employed with us before?*
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If you answered YES, When?
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Are you currently employed?*
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If you answered YES, May we contact your employer?
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Are you prevented from lawfully becoming employed in this country
because of a Visa or Immigration status?*
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Note: Proof of citizenship or immigration status will be required upon employment |
On what date would you be available to work?
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Are you available for work (Choose those that apply): * |
Full time |
Part time |
Shift work |
Temporary |
Are you currently on "lay-off" status and subject to recall?
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Can you travel if your job requires it?*
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EMPLOYMENT EXPERIENCE
Attach resume or start with your current or last job, include any job related
military service assignments and volunteer activities. You may exclude
organizations that indicate sex, race, religion, national origin, age, ancestry,
handicap, or other protected status. |
Employer:
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Dates Employed
(from
to)
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Job Title:
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Supervisor:
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Phone:
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Reason for leaving:
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REFERENCES Give name, address, telephone number or email of three references including
at least one who is a past employer. |
1.
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2.
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3.
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Have you ever had any job related training in the United States Military?*
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If YES, please describe:
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Are you physically or otherwise unable to perform the duties of the job for which
you are applying?*
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If YES, please describe:
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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 for
employment as may be necessary in arriving at an employment decision.
- This application for employment shall be considered active for a period of time
not to exceed 45 days. Any applicant wishing to be considered for employment
beyond this time period should inquire as to whether or not applications are
being accepted at that time.
- 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 the 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 execution of this
organization.
- In the event of employment, I understand that false or misleading information
given in my application or interview(s) may result in discharge. I understand,
also, that I am required to abide by all rules and regulations of the employer.
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