WORK FOR US

Employment Application

THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a pre-employment drug screening and/or medical examination. This application will remain active for 3 years.

Agreement

Applicant Certification Agreement

1.  The company and other persons or employers are released from all liability brought forth by any investigation resulting from my submission of this electronic application and the data contained here in.

2.  The information in this application is true and complete to the best of my knowledge. Any falsification, misrepresentation, or omission on this application can be cause for denial or termination of employment.

3.  If hired, my employment is voluntary, meaning that either party can employment at any time for any reason. Upon acceptance of employment if a position is offered, I agree to abide by all existing and future company rules and regulations. The company reserves the right to change any working agreement as deemed necessary.

4.  Any employment offer is contingent open my providing proof of identity and eligibility to work the country of employ.

5.  I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely and fully.

6.  I understand that by typing my name in the signature box below and submitting this application electronically, this becomes a legal and binding contract.

    Addresses


    Personal

    Current Address

    Street

    City

    State

    Zip Code

    Since (Mo/Yr)

    Prior Address

    Street

    City

    State

    Zip Code

    Since (Mo/Yr)

    To (Mo/Yr)

    Education

    High School

    School

    City

    State

    Diploma YesNo

    Undergrad School

    School

    City

    State

    Diploma YesNo

    Deg/Cert/Dip

    Area of Study

    Grad School

    School

    City

    State

    Diploma YesNo

    Deg/Cert/Dip

    Area of Study

    Other School

    School

    City

    State

    Diploma YesNo

    Deg/Cert/Dip

    Area of Study

    Employment

    Employment Information

    Position Applied For

    Date You Can Start

    Desired Salary ($)

    Do You Prefer:

    Can you work EveningsWeekends

    Available MTuWThFrSaSu

    Are you available for shift work? YesNo

    Not Available

    Please answer all of the following questions.

    1) Are you at least 18 years of age and legally eligible to work for our company in the United States? YesNo

    If you are under 18 years of age, can you provide required proof of your eligibility to work?
    YesNo

    2) Have you worked for this business before? YesNo

    If yes, please provide dates and locations

    3) Have you received a description of the job or been made aware of the essential functions of the job for which you are applying?YesNo

    4) Do you understand the job requirements?YesNo

    If no, please explain

    5) Are you on layoff and subject to recall?YesNo

    6) Are you currently bound by a noncompetition, confidentiality or trade secret agreement?YesNo

    If yes, please explain...

    7) Have you ever been discharged or asked to resign from a job? YesNo

    If yes, please explain...

    8) Have you ever been convicted of or pled guilty to a felony or crime other than a minor traffic citation? YesNo

    If yes, please explain...

    9) Do any of your friends or relatives, other than spouse, work here? YesNo

    If yes, state name and relationship...

    Employers

    Are you currently employed? YesNo

    May we contact your present employer?YesNo

    Most Recent Employer

    Employer:

    City:

    State:

    Zip Code:

    Phone:

    Position Held:

    From (m/yyyy):

    To (m/yyyy):

    Pay upon leaving:

    Supervisor:

    Duties:

    Reason For Leaving:

    Prior Employer


    Employer

    City

    State:

    Zip Code:

    Phone:

    Position Held:

    From (m/yyyy):

    To (m/yyyy):

    Pay upon leaving:

    Supervisor:

    Duties:

    Reason For Leaving:

    Skills

    Job-related Skills

    Please answer the following questions if the position you are applying for requires driving a motor vehicle:

    1) Do you have a valid driver's license? YesNo

    If yes, Driver's License Number:

    Date of Issue:

    2) Have you been convicted of or pled guilty to any traffic-related offense within the past five years? YesNo

    If yes, please explain...

    3) Have you had your driver's license suspended or revoked or had your driving privileges modified by a court of law? YesNo

    If yes, please explain...

    4) Please list all states from which you hold or held a driver's license:

    Skills:

    Professional Designations:

    References

    Name:

    Address:

    Telephone:

    Relationship:

    Years Acquainted:

    Resumes

    Resume (Text Version)

    Copy and Paste a text version of your resume here.

    Upload File

    Attach a file to your application submission (Permitted File Types: doc,docx,pdf,txt - Max file size: 1045876 bytes):-

    Type Name in Signature Box: