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Employment Application

Name:
Street Address:
City State Zip Code
Telephone Email Address

Are you currently employed?
Are you over 18 years of age?
- If not 18 years of age / date of birth (ex. 05/30/2001)
Are You authorized to work in the United States?
Have you previously worked for this company?
Are you willing to work evenings and weekends?
Have you ever been convicted (This includes pleading "no contest") of a criminal offense(s), either felony or misdemeanor? (Does not include traffic citations.)
If Yes, State the nature of the offense(s)


Will you agree to be drug tested prior to being offered a position with the company?

What type of work would you be interested in performing?
Building Maintenance
Customer Service
Food Service
Waitress
Bartender
Mechanical Repair
Management
Bookkeeping

References
Company Name
Employed From: Employed to:
Location City Location State Phone Number
Starting position Finishing position
Starting salary Finishing salary
Name of immediate supervisor
Reason for leaving


Company Name
Employed From: Employed to:
Location City Location State Phone Number
Starting position Finishing position
Starting salary Finishing salary
Name of immediate supervisor
Reason for leaving


Company Name
Employed From: Employed to:
Location City Location State Phone Number
Starting position Finishing position
Starting salary Finishing salary
Name of immediate supervisor
Reason for leaving


High School Years completed
Did you graduate


College Years completed
Did you graduate?


Trade School Years completed

Important: This application will aid us in obtaining a clear understanding of you qualifications to fill the specific job openings. We are an Equal Oppertunity Emplory. Complete all the information on the application, as we cannot consider you for employment unless all the requested information is provided by you. If you have additional information that will help us to further evaluate you as a potential employee (such as a resume) please attach it to this application when completed.

I understand that if I am employed, any misrepresetation or material omission made by me on this application will be sufficent cause for the cancellation of this application or immediate discharge.

In connection with my application for employment with this company, I understand that a consumer report or an investigative consumer report may be requested that will include information as to my character work habits, performance, and experience, along with reasons for temination of past employment. I understand that as directed by company policy and consistent with the job decribed you may be requesting information from the public and private source about my workers compensation injuries, driving record, court records, eduction credentials and refrences.

Enter your intials and date this is for you signature


Upload any files such as a resume

Questions & Comments

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