Employment Application

IT IS OUR POLICY TO SEEK AND EMPLOY THE BEST QUALIFIED PERSONNEL AND TO CONSIDER ALL APPLICANTS
WITHOUT REGARD TO RACE, COLOR, RELIGION, AGE, SEX, NATIONAL ORIGIN OR DISABILITY THAT CAN BE
REASONABLY ACCOMMODATED WITHOUT UNDUE HARDSHIP.

READ CAREFULLY BEFORE COMPLETING THIS APPLICATION

I understand that neither this completed application nor a commitment of employment if made, constitutes a contact of employment. Further, that if I am hired my employment will be at-will, meaning that either myself or my employer may terminate the employment relationship at any time, with our without cause and with or without notice. Offers of employment, if made, become effective only when and if all hiring requirements are satisfactorily completed. Physical exams, drug/alcohol screening, background checks including employment, criminal and driving records may be required. Licensing or other certifications may be required for certain positions. I authorize the investigation of all statements I made on this application or any interviews I may have in the future. If offered employment, I authorize the background records and reference checks required for employment and release those contacts to give any and all pertinent information, personal or otherwise.

I further release and agree to hold harmless this organization and all parties providing information from all liability for any claims or damage that may result from furnishing such information to you. The information I will give on this application will be true and complete to the best of my knowledge and belief, with my understanding that any false information given now or at any interview will be sufficient reason for immediate dismissal. I have read the preceding information and agree to complete and submit my application for employment accordingly.

Regular Part Time Seasonal/Temporary

PERSONAL DATA

Yes No
Yes No
Yes No
Yes No

The following conditions may be rquired at some point If under 18, do you have a work permit? Yes No in an hourly paid job assignment. If rquired, would you be willing to work:

Yes No
Yes No
Yes No
Yes No

EDUCATIONAL DATA

Yes No
Yes No
1 2 3 4 5 6
Yes no

WORK HISTORY

WORK HISTORY 1

Yes no
Remove
Add New Work History

USE THIS SPACE TO PROVIDE REFERENCES AND ADDITIONAL INFORMATION
THAT WILL HELP US CONSIDER YOUR APPLICATION

Please list three references with names, their relationship to you and their phone numbers, including area codes

REFERENCE 1

REFERENCE 2

REFERENCE 3

Summarize any special job-related skills, qualifications or educational experiences. Include any additional information which you believe will be helpful in considering your application for employment