Application Information

We are an equal opportunity employment company. We are dedicated to a policy of nondiscrimination in employment on any basis including, rade, creed, color, age, sex, religion, national origin, or status as a qualified individual with a handicap. Please answer each unless specifically prohibited by law.


Present Address:

Are you legally eligible for employment in this country?

Proof of US citizenship or immigration status will be required upon hire)

Will you submit to a job related physical examination at our request and expense?

Do you have any concerns which may restrict you from performing assigned duties?

If yes, please explain

Do you have a valid drivers license?

Have you ever been convicted of a felony?

If yes, describe in detail. Disclosure of a criminal record does not automatically disqualify you from employment consideration.


Person to be notified in case of account or emergency


Work Interest


Education

High School

Did You Graduate?*
YesNo

College

Did You Graduate?*
YesNo

Business or Trade School

Did You Graduate?
YesNo

Professional School

Did You Graduate?
YesNo


Previous Employment

May we contact your previous supervisor for a reference?*
YesNo

May we contact your previous supervisor for a reference?
YesNo

May we contact your previous supervisor for a reference?
YesNo


Account for all periods of unemployment during the last five years in your employment history

Special Skills or Qualifications - list machines operated, licenses, office equipment, typing (wpm), Microsoft Office, Excel, Word etc:

PLEASE READ CAREFULLY – Applicant’s Certification Agreement

It is understood and agreed that any misrepresentation or omission by me in the application will be sufficient reason for cancellation of this application from the employers service, if I have been employed. Furthermore, I understand and agree that if I am ired, my employment with the company will be at will, and may be terminated by me or the company, with or without notice or cause. I also understand that, if hired, from time to time I may receive pay increases, bonuses, promotions, evaluations, demotions, discipline and the like, none of which is intended to alter the at-will nature of my employment. I understand that this arrangement may be changed only in writing when signed by me and the president of the company.

I understand that neither this document or any other offer of employment constitutes an employment contract. I give the Employer the right to investigate all references, plus my personal history through any investigative credit agency or bureau. I release from liability the Employer and its representatives for seeking such information. I agree to submit to a job related pre-employment physical which includes a urine/blood test for substance abuse and/or chemical dependency, unless prohibited by law. If I am hired, I understand and agree that uon probably cause, I may be required to submit to a physical examination and /or urine/blood test analysis. The results of these examinations may be grounds for disciplinary action up to and including termination.

If am hired, I agree to abide by the rules of the company. I agree to be available for overtime and work on weekends and holidays when scheduled by the company. I understand that failure to do so would be grounds for disciplinary action up to and including termination.
This application is current for 60 days. At the conclusion of this time if I have not heardfrom the employer and still wish to be considered for employment. It will be necessary for me to fill out a new application.

Do you agree to the statements above?
YesNo