PERSONAL INFORMATION Phone * Email * Position Desired * Date Available * Have you ever filled out an application with us before? * Have you ever been employed with us before? * We work on a full time schedule. Is that a problem? * We occasionally work more than eight (8) hours per day and on holidays. Will this be a problem? * If employed, and you are under 18, can you furnish a work permit? Can you perform the essential functions of the job you have applied for? EMPLOYMENT EXPERIENCE *Please list full and part time jobs you have had over the past 7 years, listing your most recent job FIRST. (Alternatively, you may attach a current resume, if you wish.) Please include: 1) Employer 2) Job Title 3) Start Date & End Date 4) Full time or Part time 5) Starting & Ending Pay 6) Supervisor + Phone Number 7) Reason for Leaving *
List all full and part time jobs you have had in the past 7 years. Include any job related military service assignments and volunteer
activities. You may exclude organizations which indicate race, color, religion, sex, national origin, handicap or other protected status.
Upload a Resume or a List of Past Work Experience (Optional, or in place of above.) REFERENCES
Please list the names of persons not related to you willing to provide professional or character references for you. Give name, address and telephone number.
Reference #1 - Name and Address * --- Reference #1 - Phone and/or Email * Reference #2 - Name and Address * --- Reference #2 - Phone and/or Email * Reference #3 - Name and Address * --- Reference #3 - Phone and/or Email * EDUCATION *Please list your EDUCATION, (or alternatively, you may attach a current resume, if you wish.)
1) grammar school, high school, college and other education. 2) Names & locations of schools 3) Did you graduate? 4) Years attended and degree or diploma, if relevant.
Optional: (Attach Resume in place of above education, if you like.) GENERAL INFORMATION List special skills, talents or experience you feel will benefit you in the job for which you have applied: * List all convictions for misdemeanors, felonies, or other offenses, except minor traffic violations (if none write none): * List all pending misdemeanor, felony or other criminal charges (if none, write none): *
*No applicant will be denied a position because of a conviction or a pending criminal charge which the employer determines is not substantially
related to the circumstances of the job being sought.
MILITARY SERVICE (if applicable) Have you served in the U.S. Armed Forces? If not, you may skip to the next section. APPLICANT'S STATEMENT
"I certify that answers given herein are true and complete to the best of my knowledge.”
I understand that I may be required to submit to a post-employment offer physical examination and/or a drug
screen, and that employment is conditioned upon obtaining satisfactory results. I consent to this post-employment offer physical examination and such further examinations as may be required, which may include drug screenings.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
I understand that, if hired, any employment relationship with this Company 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. I also understand that acceptance of an offer of employment does not create a contractual
obligation to continue to employ me in the future and that no Company official, management or otherwise, is authorized to make any oral assurance or promise of continued employment, and that any such pledge or agreement must be in writing, signed by the President of the Company.
I 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.
AGREEMENT with the ABOVE STATEMENT (Required.) *