Application of Employment
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| Personal Information: |
Position Applied For:
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Date of Application:
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Name:
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Address:
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Phone Number:
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If you are under 18 years of age, can you provide required proof or eligibility to work?
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Yes
No |
| What is your birth date? |
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| Do you have a valid ID? |
Yes No |
| Do you have reliable transportation? |
Yes No |
Do you have the tools of the trade? If no, what do you have?
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Yes No |
Have you ever filed an application with us before? If Yes, please provide date:
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Yes
No
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Are you currently employed?
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Yes
No |
May we contact your employer?
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Yes
No |
Are you prevented from lawfully becoming employed in the country because of Visa or Immigration status?
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Yes
No |
On what date are you available to work?
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| Are you available to work full time? |
Yes
No |
Are you currently on “lay-off” status or subject to recall?
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Yes
No |
Can you travel if the job requires it?
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Yes
No |
Have you been convicted of a felony within the last 7 years?
(Conviction will not necessarily disqualify an applicant from employment.)
If yes explain:
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Yes
No |
Indicate any Foreign Languages you can speak:
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Have you had any job training in the United States Military?
If yes, please describe:
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Yes
No |
| Employment Experience: |
Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap, or other protected status.
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Employer:
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Dates Employed:
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Telephone Number:
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Reason for Leaving:
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Work Performed:
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Employer:
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Dates Employed:
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Telephone Number:
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Reason for Leaving:
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Work Performed:
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Employer:
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Dates Employed:
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Telephone Number:
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Reason for Leaving:
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Work Performed:
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Summarize special job-related skills and qualifications acquired from employment or other experience:
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| School Name: |
High School:
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Year Completed:
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College/University
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Year Completed:
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| Hobbies: |
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| References: |
| Give name, address, and telephone number of three references who are not related and are not previous employers: |
1: Name of Reference
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Name of Company
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Reference Phone Number
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Reference City
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Description of Performance:
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2: Name of Reference
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Name of Company
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Reference Phone Number
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Reference City
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Description of Performance:
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3: Name of Reference
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Name of Company
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Reference Phone Number
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Reference City
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Description of Performance:
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Applicant's Certification Agreement:
- I certify that the facts and information set forth in this application are true and complete of the best of my knowledge. I understand that a falsification, misrepresentation, or omission of facts on the application (or any required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.
- I authorize the investigation of all statements contained in the application and release from all liability any persons or employers supplying such information, and I also release the company from all liability that might result from making the investigation.
- If I am offered and accept a position, I agree to conform to all existing and future Company rules and regulations and I understand that the Company reserves the right to change wages, hours and working conditions as deemed necessary. I ALSO UNDERSTAND THAT, IF HIRED, MY EMPLOYMENT WILL BE AT-WILL, MEANING THAT EITHER PARTY CAN END THE EMPLOYMENT RELATIONSHIP AT ANY TIME AND FOR ANY OR NO REASON.
- I understand that any employment offer is contingent upon my providing, within three (3) working days of employment, valid proof of identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986.
- I have read and reviewed the information provided in this application and the above statements. By submitting this application for employment I certify that I understand all parts of it and have answered all questions completely and fully.
By clicking the “send” button below, I hereby agree to the APPLICANT’S CERTIFICATION AGREEMENT |
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