Employment Application

We consider applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability or any other factor whose consideration is prohibited by applicable law.

Have the essential functions of the position for which you are applying been explained to you?
Are you able to perform the essential functions of the position?
Who referred you to the Company
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Are you available to work overtime if required?
Are you available to work
If under 18 years of age, can you provide proof of your eligibility to work?
Can you travel if a job requires it?
Have you ever been convicted of a misdemeanor?
Have you ever been convicted of a felony?

A misdemeanor and/or felony conviction does not disqualify you from being offered employment.

Have you ever been employed with us before?
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Have you ever filled an application with us before?
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Are you legally eligible to work in the US? (Note: Verification will be required upon hire)

Education

High School

Undergraduate College

Graduate / Professional

Post Graduate, Business, Technical, Other

Professional Certificates & Licenses

Work Experience

Employer #1

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May we contact this employer?

Employer #2

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May we contact this employer?

Employer #3

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May we contact this employer?

Employer #4

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May we contact this employer?
Personal/ Professional References (Do not list former employers or relatives.)
Name
Occupation
Phone Number
 

APPLICANT’S CERTIFICATION AND AUTHORIZATION

READ CAREFULLY



I affirm that all of the above information is true, correct and complete. I understand that any information provided by me above and/or in connection with my application for employment that is found to be false, incomplete or misrepresented in any respect will cancel further consideration of this application or subject me to immediate discharge from the Company whenever it is discovered. I believe that information concerning my performance as an employee, as well as information concerning my personal habits, conduct, deportment, as well as the information outlined hereinabove; will assist me in obtaining employment with the Company. Therefore, in consideration for the Company’s act of considering me for employment, I hereby agree to release and hold harmless the Company, together with its officers, agents, employees, affiliated corporations, subsidiaries, successors and assigns, from any and all liability in any way related to the investigation of my suitability for employment with the Company, including, but not limited to, any liability relating to contact and/or discussions with any of my employers, relatives, and/or acquaintances (past and/or present.) Moreover, I specifically authorize any person (natural or otherwise) to make full response to any inquiry in connection with my application for employment with the Company, and I release any such persons from all liability arising there from. I understand and acknowledge that in the event I am employed by the Company, my employment is not for any specific length of time but, rather, is of an “at-will” nature, which means that I may resign at any time and the Company may terminate my employment at any time with or without cause. I understand that no present or future employee handbook, policy manual, work rules or publication constitutes an employment agreement or contract. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is acknowledged in writing signed by both me and an authorized executive of the Company.

I agree