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APPLICATION FOR EMPLOYMENT

  • PROVIDE YOUR PHONE NUMBER
  • IF EMPLOYED AND UNDER 18 YEARS OF AGE, CAN YOU FURNISH A WORK PERMIT?
  • IF YES, GIVE DATE
  • IF YES, GIVE DATE
  • IF YES, MAY WE CONTACT YOUR PRESENT EMPLOYER?
  • (PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT)
  • (CONVICTION WILL NOT NECESSARILY DISQUALIFY APPLICANT FROM EMPLOYMENT)
  • If Yes, Please Explain:
  • HIGHEST LEVEL OF EDUCATION COMPLETED?
  • GIVE NAME, ADDRESS, AND TELEPHONE NUMBERS OF THREE REFERENCES WHO ARE NOT RELATED TO YOU AND ARE NOT PREVIOUS EMPLOYERS:

  • EMPLOYMENT EXPERIENCE:

    START WITH YOUR PRESENT OR LAST JOB. INCLUDE MILITARY SERVICE ASSIGNMENTS AND VOLUNTEER ACTIVITIES. (YOU MAY EXCLUDE ORGANIZATION NAMES THAT WOULD REVEAL SEX, RACE, RELIGION, NATIONAL ORIGIN, AGE, ANCESTRY, DISABILITY OR OTHER PROTECTED STATUS.)
  • APPLICANT'S STATEMENT

    I CERTIFY THAT ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION FOR EMPLOYMENT AS MAY BE NECESSARY IN ARRIVING AT AN EMPLOYMENT DECISION. THIS APPLICATION FOR EMPLOYMENT SHALL BE CONSIDERED ACTIVE FOR A PERIOD OF TIME NOT TO EXCEED 180 DAYS. IF I WISH TO BE CONSIDERED FOR EMPLOYMENT BEYOND THIS PERIOD, I UNDERSTAND THAT I NEED TO INQUIRE AS TO WHETHER OR NOT APPLICATIONS ARE BEING ACCEPTED AT THAT TIME. I UNDERSTAND THAT NEITHER THIS DOCUMENT NOR ANY OFFER OF EMPLOYMENT FROM THE EMPLOYER CONSTITUTES AN EMPLOYMENT CONTRACT UNLESS A SPECIFIC DOCUMENT TO THAT EFFECT IS EXECUTED BY THE EMPLOYER AND ME IN WRITING. IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW(S) MAY RESULT IN DISCHARGE. I UNDERSTAND, ALSO, THAT I AM REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF THE EMPLOYER.