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I certify that the information provided on this application is true and I understand that my application will not be considered if it is incomplete. Further, I understand that any misrepresentation for omission when discovered, will subject me to discharge and I hereby authorize any investigation of the above or related work experience, education, or reputation information for purposes of consideration of my application for employment.
I give the company authorization to contact and obtain information from all references, employers, educational institutions and to other wise verify the accuracy of information contained in this application. I also release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.
I understand and agree that if offered employment by the company, I may be required to disclose pending arrest information and criminal conviction information in accordance with the law, and that any such employment offer shall be dependent upon the receipt of a satisfactory arrest and/or conviction record as determined by the company.
I understand that if I am hired, I will be required to provide proof of identity and legal work authorization.
I have read, understand and agree that all of the above terms will apply should I be hired by the company, and I seek employment under these conditions.
Position Applying For* (Check all that apply)
High School - Name
High School - Address
High School - No. of Years or Degree
College School - Name
College School - Address
College School - No. of Years or Degree
Other School - Name
Other School - Address
Other School - No. of Years or Degree
Is there any information we would need about your name for us to check your work record? Please specify.
Do you know anyone presently working for our Company?
How were you referred to the Company?
You may also attach a resume. (5MB limit. PDF, DOC, or DOCX)
Position and Duties
Must not be relatives.
If your application receives favorable consideration, what salary/hourly rate would you require?*
After an offer of employment is made, but before employment duties begin, applicants will be required to take and pass a drug test at the applicant's expense and will be reimbursed after completion of a ninety (90) orientation period. Applicants may also undergo a physical or medical examination at Company expense and by a Company-chosen physician, with the offer of employment conditioned on the result of such examination. Employees, at any time during the course of their employment, may be required to undergo a medical examination at Company expense and by a Company-chosen physician. I authorize the physician conducting the examination and any laboratory testing any specimen obtained by the physician to disclose the results of the examination and the laboratory test to the Company.
Are you able to perform the essential functions of this job with or without reasonable accommodation? If not, specify.*
It is the policy of this Company to hire only U.S. citizens and aliens who are authorized to work in this country. (As a condition of employment, you will be required to produce original documents establishing your identity and authorization to work, and to complete the U.S. Immigration and Naturalization Service's Form I-9).
In connection with my application for employment, I understand and agree that background inquiries may be requested by you or on your behalf that will seek information as to my character, work habits, including oral assessments of my job performance, experiences and abilities, along with reasons for termination of past employment. Furthermore, I understand and agree that you may request information from various federal, state and other agencies, including public and private sources which maintain records concerning my past activities relating to my previous employment, educational background, and other past experiences.
I acknowledge that a telephonic facsimile or copy of this release shall be as valid as the original. This release is valid for all federal, state, county, and local agencies and authorities.
The following is my complete and legal name, and all information is true and correct to the best of my knowledge.
Former Name - 1
Previous Address - 1
Former Name - 2
Previous Address - 2
This application is not a contract and cannot create a contract. I understand that if I am employed, my employment is "at will" and can be terminated at any time, either by myself or the Company, with or without cause or reason and with or without notice.