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  Employment Application


Prospective employees will receive consideration without discrimination based 
on race, creed, color, sex, age, national origin, veteran status, marital status,
disability, handicap, sexual orientation, citizenship status or any condition
prescribed by state or local law.

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Name

First Name

Last Name

Middle Name

Subject

Today's Date

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Best Contact #

(###)

###

####

Social Security Number

Have you ever applied for employment with us?

Pay Desired

Pay Expected

Apart from absence for religious observance, are you available for full-time work?

Will you work overtime if asked?

Are you legally eligible for employment in the United States?

When will you be available to begin work?

YYYY

Other special training or skills (languages, machine operation, etc.)

Have you ever been bonded?

EDUCATION

Most Recent Degree or Diploma

Name & Location of School/Course of Study/# of Years Completed/Are you still attending?

EMPLOYMENT

Company Name/Name of Supervisor/Job Title & Description of Work

Company Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Company Phone

Best Contact #

(###)

###

####

Dates Employed (Month & Year)

Reason for Leaving

Company Name/Name of Supervisor/Job Title & Description of Work

Company Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Company Phone

Best Contact #

(###)

###

####

Dates Employed (Month & Year)

Reason for Leaving

May we contact the employers listed above?

YES

MILITARY

Did you serve in the U.S. Armed Forces?

Describe any training received relevant to the position for which you are applying.

ADDITIONAL INFORMATION

Membership in professional and civic organizations, special accomplishments awards, etc. (Exclude those which may disclose your race, color, religion, age or national origin).

APPLICANT’S DIGITAL ACCEPTANCE/SIGNATURE

Please read and understand this statement before digitally agreeing to submit your application. The information I have provided in this Application for Employment is true, correct and complete. False, incomplete or misrepresented information of any kind, will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment. I authorize the employer to contact and obtain information about me from previous employers, educational institutions and “references” I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, a related employment resume or a personal interview to assist in the processing of my Application, I waive all rights and claims I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose. This application will expire in 30 days. After that date, unless otherwise notified, I understand that my status as an applicant will end. I may re-apply for employment in the future by completing a new application, This application is not an employment agreement. If I accept an offer of employment the employer may terminate my employment at any time, with or without cause and without notice, unless required by law. I understand that no one, other than an executive office of the employer, has authority to enter into any employment agreement with terms contrary to the foregoing and then only in writing signed by such offer. Is there a separate section of background checks (we can include "I authorize the prospective employer to investigate my background, references, character, past employment, consumer report, education, and any record of criminal history for the purpose of confirming the information contained in this application and/or obtaining other information which may be material to my qualification for employment.

DIGITAL ACKNOWLEDGMENT

I fully understand and accept all terms and conditions in the above statement.

YES

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