Employment Opportunities

To our candidate: We deeply appreciate your interest in our company and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will enable us to place you in a position that best suits your qualifications and may assist us in possible future promotions. Candidates are considered for all positions without regard to race, sex, religion, national origin, age, marital or veteran status or the presence of a non-job related medical condition or handicap. All employees are employees at will with no implied contract.

Required fields in red

Name (first, middle, last):
Street Address:
City:
State:
Zip Code:
Phone Number:
Email:
Are you 18 or older?	Yes No

EMPLOYMENT HISTORY (Four Most Recent Jobs):

May we contact your present/past employers? Yes No, explain

(If not applicable, list US military, volunteer work, or personal references)

Company:		Location:
Phone:		Job Title:
Supervisor:		Dates Worked (From/To):
Salary:		Reason for Leaving:

Company:		Location:
Phone:		Job Title:
Supervisor:		Dates Worked (From/To):
Salary:		Reason for Leaving:

Company:		Location:
Phone:		Job Title:
Supervisor:		Dates Worked (From/To):
Salary:		Reason for Leaving:

Company:		Location:
Phone:		Job Title:
Supervisor:		Dates Worked (From/To):
Salary:		Reason for Leaving:

EDUCATION

School	City/State	# Of Years Completed	Diploma/Degree/License/Certificate
High School

College

REFERENCES

Please provide the names of three persons not related to you, whom you have known for at least one year.

	Name	Address	Occupation	Years Acquainted
1
2
3

AVAILABILITY

Total Hours Available Per Week:
Hours of Availability (From/To)
Are you legally able to be employed in the US? (Proof of citizenship or immigration status is required upon employment)	Yes No
How did you hear of the job?
How far do you live from location?
Do you have the transportation to work?	Yes No
On what day will you be available to work?
Positions applied for:
Desired salary:

ADDITIONAL INFORMATION

Do you have a friend or relative in our employ?	Yes No
If yes, state name and position

Have you been previously employed by our company?	Yes No
If yes, where, when, and in what capacity?

In the past 7 years, have you ever been convicted of a crime, excluding misdemeanors and traffic violations?	Yes No
If yes, please describe in full. A conviction will not necessarily bar you from employment.

AGREEMENT

Candidate please read and attest to the following statement.

I certify that the information I have given on this application is true and complete and understand that any false or misleading information given, or the omission of any pertinent information may result in my discharge at any time, if I am hired. I hereby authorize the Company to investigate my record with my former employers and personal references. If hired, I agree to abide by the policies, rules, and expectations of the Company. I also understand that my employment is "at will" and that I can resign at any time and that I can be terminated at any time. Nothing herein or during my employment shall be considered an employment contract.

I attest.

Date of Application: