Application for Employment

Applicants are considered for all positions without regard to race, color, religion, age, sex, marital status, national origin, veteran status, sexual orientation or the presence of a non-job related medical condition, disability or handicap. It is a company policy to provide a non-smoking work environment for all employees. Smoking is not permitted in company offices or common areas of the building. Thank you for completing this application form and for your interest in employment with our company. Employment will be subject to satisfactory reference checks and a pre-employment examination that will include a drug and alcohol screening in accordance with state and federal law.

Personal Information

Are you a contractor?

Yes No

Last Name*

First Name*

Middle Name

Street Address*

City*

State*

Zip Code*

Phone*

Business Phone

Email*

Position Applied For

Desired Salary

Referral

Date Available

Education

School

School Name

School Full Address

Course of Study

# of years completed

Graduated?

Degree or Diploma?

+ Add education

Military Service

Branch of Service

From Date

To Date

Rank & Type of Service

Training & Experience Received

Employment Experience

Please start with present or most recent employer

Employer

Address

Phone

Job Title

Supervisor

Reason for leaving

Employed Since

Employed To

Salary Start

Salary End

Work Performed

+ Add employment

Special Skills & Qualifications

Summarize special skills, qualifications, licenses, hobbies, professional, business or civic experiences that you think would especially qualify you for employment. You may exclude those which indicate race, religion, sex or national origin.

References

Anyone other than your relatives.

Name

Address

Phone

Occupation

Years known

Relation to you

+ Add reference

I understand that employment will be subject to submitting documentary proof of my identity and legal eligibility to work.
I understand that the employer follows an "employment at will" policy, in that I or the employer may terminate my employment at any time or for any reason consistent with applicable state or federal law.
I understand that this application is not a contract of employment.
I understand that the company will thoroughly investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested about me and I release them from all liability for damage in providing this information.
I certify that all the statements herein are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal of employment.

Signature*

Today's Date*

I have read and agreed to all applicable policies such as Pre-Employment Background Check, Sexual Harassment Policy and Rules & Regulations.