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General Applications
I represent and warrant that, by submitting this application, I have read and fully understand the terms below & that I seek employment under the described conditions:
I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered. If I am employed, I acknowledge that there is no specified length of employment, and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law. I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that person’s need for a reasonable accommodation as required by the ADA. I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment. Finally, I agree to receive text messaging and/or email from the employer as required and understand that I may opt-out of said messaging through verbal or written notice to HR.
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First Name
*
Last Name
*
Phone
*
Email
*
Best Time to Reach You
Driver License Number
*
If you do not have a license, please enter "N/A".
Address
City
State
Zip Code
*
Employment Desired
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Full Time
Part Time
Full or Part Time
Desired Pay
*
Date Available
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Proof of Legal employment?
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Yes
No
Can you provide legal proof of Identity and authorization to work?
Source
Have you worked here before?
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Yes
No
Able to meet attendance requirements?
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Yes
No
Do you have a reliable source of transportation and are you able to meet attendance requirements?
Willing to work Overtime?
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Yes
No
Able to travel?
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Yes
No
Are you able and willing to travel if necessary for the position?
If you are under the age of 18, can you furnish a work permit?
*
I am 18 or older
Yes
No
In the past 7 years, have you been convicted of a crime? Yes or No
*
Yes
No
if yes, please explain. A conviction will not automatically bar employment.
If currently employed, may we contact your employer?
*
Yes
No
Not currently employed
Work History
Job 1
Job Title
Company Name
City
State
Supervisor's Name
Supervisor's Phone
Start Date
End Date
Summary
Reason for Leaving
Job 2
Job Title
Company Name
City
State
Supervisor's Name
Supervisor's Phone
Start Date
End Date
Summary
Reason for Leaving
Job 3
Job Title
Company Name
City
State
Supervisor's Name
Supervisor's Phone
Start Date
End Date
Summary
Reason for Leaving
Highest completed level of education
High School
Technical Training
College - Associate's Degree
College - Bachelor's Degree
Other
Skills
References or additional comments
Please provide name and phone number for any references
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