Employment Application

We appreciate your interest in employment and assure you that we are interested in your qualifications. An understanding of your background and work history is necessary for us to properly place you in an available position.

Personal
Address
EDUCATION RECORD #1
EDUCATION RECORD #2
WORK HISTORY #1
Beginning with the most recent, list below all past employers, including any pertinent experience
WORK HISTORY #2
Beginning with the most recent, list below all past employers, including any pertinent experience
EXTRA CURRICULAR AND SPECIAL ACTIVITIES ATHLETICS, CLUBS, ETC. #1
(Do not include Military, Racial, Religious, or Nationality Groups)
EXTRA CURRICULAR AND SPECIAL ACTIVITIES ATHLETICS, CLUBS, ETC. #2
(Do not include Military, Racial, Religious, or Nationality Groups)
PERSONAL REFERENCES #1
(Not former employers or relatives)
PERSONAL REFERENCES #2
OTHER
Address
ARE YOU AUTHORIZED TO WORK IN THE UNITED STATES?
HAVE YOU EVER BEEN CONVICTED OF A FELONY?
HAVE YOU PREVIOUSLY APPLIED HERE
HAVE YOU EVER WORKED ANYWHERE UNDER A DIFFERENT NAME?
Questions
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1 being the most important and 5 being the least important

Affidavit

I certify that all information I have provided in this 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 understand that the employer may request an ivestigative consumer report from a consumer report agency. This report may include information as to my character, reputation, person characteristics, and mode of living obtained from neighbors, friends, former employers, schools, and others. I understand that I have a right to make a written request within a reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature and scope of the investigation. I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations named in this application 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 UNDERSTAND THAT THIS APPLICATION OF SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. 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 CAUSE AND WITH OR WITHOUT NOTICE. I have read, understand and by my signature consent to these statements.

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