EMPLOYMENT APPLICATION

FAIR EMPLOYMENT: It is the policy of employer to prohibit unlawful discrimination on the basis of any characteristic protected by applicable local, state, or federal law. If you believe your equal employment rights have been violated, you may contact the appropriate state or federal EEO agency.

Name(Required)
Address(Required)

Most Recent Previous Address

Prior Previous Address

Are you age 18 or older?
Are you interested in:
Willing to work overtime?
Have you previously been employed here?
Have you applied here before?
Are you presently employed?
May we inquire of your employer?
Are you on layoff and subject to recall?
If employed, can you submit verification of your right to work in the US?

EDUCATION AND SKILLS

Check the boxes that indicate all levels of completed education:
Trade or Business School

GENERAL INFORMATION

EMPLOYMENT HISTORY/PERSONAL REFERENCES

List ALL periods of employment, self-employment, U.S. military service, volunteer work, and/or non-employment starting with the MOST RECENT FIRST. Personal references may be listed following employment history—please do not list relatives

Address
Address
Address
Address
Please Select
Address
Please Select
Address

CERTIFICATION AND ACKNOWLEDGMENT

I certify that all information submitted in this application form, or in any resume, interview, or other information, is true and complete and that l have not knowingly withheld, nor will I withhold, any information that would affect my application for employment. I understand that employer is under no obligation to consider or reconsider this application at any time, and that acceptance of my application does not constitute an offer of employment.

I ALSO UNDERSTAND AND AGREE THAT:

1. Inquiries may be made with my previous employers, personal references, and others (herein collectively "persons") who may have knowledge of me. I authorize such "persons" to give you any and all information concerning my previous employment (including but not limited to, an assessment of my job performance, ability, and fitness for employment), and/or any other information they may have. I release all such persons from any and all liability, claims, or damages that may directly or indirectly result from furnishing same. Upon my reasonable and timely request, a description of the general scope and nature of any such inquiry will be provided to me to the extent required by applicable law.

2. Prior to my beginning work or during my employment, employer reserves the right to require any lawful form of medical, drug, alcohol, psychological, character, honesty, integrity, aptitude, skill, or other test or examination.

If employed, I understand and agree that my employment is “at-will” and may be terminated with or without cause or notice at my option or at the option of employer.

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