Employment Application





SHIFT DESIRED 1st 2nd

DATE YOU CAN START?

SALARY DESIRED

EDUCATION HISTORY

NAME         YEARS ATTENDED     DID YOU GRADUATE     SUBJECTS STUDIED
HIGH SCHOOL            
COLLEGE            
TRADE/
BUSINESS/
CORRESPONDENCE
SCHOOL 		           

GENERAL INFORMATION

SPECIAL TRAINING
SPECIAL SKILLS
US MILITARY OR NAVAL SERVICE
   RANK

EMPLOYMENT HISTORY

MONTH AND YEAR     NAME & ADDRESS     SALARY     POSITION     REASON FOR LEAVING
FROM
                
TO
FROM                
TO
FROM                
TO
FROM                
TO
FROM                
TO

REFERENCES

NAME     ADDRESS     BUSINESS     YEARS KNOWN
           
           
           

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand falsified statements on this application shall be grounds for dismissal.

I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment.

In compliance wit federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

I authorize investigation of all statements contained herein and the references and employers listed about to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company form all liability for any damage that many result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing unless it is in writing and signed by an authorized company representative.