APPLICATION FOR EMPLOYMENT
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legallly protected status.
First Name: Last Name:
Address: (Number, Street, City, State and Zip Code):
Telephone Number(s):
Social Security Number:
Position(s) Applied For:
If you are under 18 years of age can you provide required proof of your eligibility to work? Yes No
Have you ever filed an application with us before? Yes No If Yes, give date
Have you ever been employed with us before? Yes No If Yes, give date
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? Yes No (Proof of citizenship or immigration status will be required upon employment.)
On what date would you be avilable for work?
Are you avilable to work: Full Time / Part Time / Shift Work / Temporary
Are you currently on "lay-off" status and subject to recall? Yes No
Can you travel if a job requires it? Yes No
Have you been convicted of a felony within the last 7 years? Yes No (Conviction will not nessarily disqualify an applicant from employment.)
If Yes, please explain : Type comments here.
EDUCATION
Elementary School
Name and Address of School
Course of Study
Years Completed Diploma Degree
High School
Undergraduate College
Graduate Professional
Other (Specify)
Indicate any foreign languages you can speak, read and / or write
Fluent Good Fair
Describe any specialized training, apprenticeship, skills and extra-curricular activities.
Type comments here.
Describe any job-related training received in the United States millitary.
EMPLOYMENT EXPERIENCE
Start with your last job. Include any job related millitary service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.
1. Employer Address
Telephone Number Job Title Supervisor
Dates Employed: From To Hourly Rate/Salary Starting Final
WorkPerformed
Reason for leaving
2. Employer Address
3. Employer Address
4. Employer Address
REFERENCES
1.Name Phone#
2.Name Phone#
3.Name Phone#
By clicking the submit button I certify that answers given herein are true and complete to the best of my knowledge.
By clicking the submit button I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization 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. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such charge is specifically acknowledged in writing by an authorized executive of this organization.
In the event of employment, I understand that false or misleading information giving 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.