Applicants are considered for all positions without regard to race, color, religion,sex, national origin, age, marital or veteran status, or the presence of a non-job related medical condition or handicap.Part One Date of Application* Date Format: MM slash DD slash YYYY Position(s) Applied For:*Referral Source:*AdvertisementFriendRelativeWalk-InEmployment AgencyYour InformationApplicant Email* Last Name*First*MiddleSkills & ExperienceElectricalPlumbingPaint Color MatchingBuilding constructionLock servicing Place "X" in all that apply.Applicant Phone*If employed and you are under 18, can you furnish a work permit?*YesNoHave you filed an application here before?*YesNoIf yes, give date*Have you ever been employed here before:*YesNoIf yes, give date:*Are you employed now?*YesNoMay we contact your present employer?*YesNoIf hired, can you furnish proof you are legally entitled to work in the United States?*YesNoOn what date would be be available to work?* Date Format: MM slash DD slash YYYY Are you available to work:*Full TimePart-TimeShift WorkTemporaryCan you travel if a job requires it?*YesNoHave you been convicted of a felony within the last 7 years?*YesNo(Conviction will not necessarily disqualify applicant from employment.)If yes, please explain:*Please list days/times available for each day the week:*SundayMondayTuesdayWednesdayThursdayFridaySaturday For example: 10-3, 7-9, etc.Section BreakEmployment Experience Start with your present or last job. Include military service assignments and volunteer activities. All information should be completed and feasons for any time lapse should be noted. Employer 1Company NameEmployer 1 PhoneSupervisor 1 Name: First Last Employed From 1: Date Format: MM slash DD slash YYYY Employed To 1: Date Format: MM slash DD slash YYYY If still employed here, don't fill in the date.Your job title 1:Work Performed 1:Hourly Rate/Salary to Start 1:Hourly Rate/Salary Final 1:Employer 2Company NameEmployer 2 PhoneSupervisor 2 Name: First Last Employed From 2: Date Format: MM slash DD slash YYYY Employed To 2: Date Format: MM slash DD slash YYYY If still employed here, don't fill in the date.Your job title 2:Work Performed 2:Hourly Rate/Salary to Start 2:Hourly Rate/Salary Final 2:Employer 3Company NameEmployer 3 PhoneSupervisor 3 Name: First Last Employed From 3: Date Format: MM slash DD slash YYYY Employed To 3: Date Format: MM slash DD slash YYYY If still employed here, don't fill in the date.Your job title 3:Work Performed 3:Hourly Rate/Salary to Start 3:Hourly Rate/Salary Final 3:Employer 4Company NameEmployer 4 PhoneSupervisor 4 Name: First Last Employed From 4: Date Format: MM slash DD slash YYYY Employed To 4: Date Format: MM slash DD slash YYYY If still employed here, don't fill in the date.Your job title 4:Work Performed 4:Hourly Rate/Salary to Start 4:Hourly Rate/Salary Final 4:Employer 5Company NameEmployer 5 PhoneSupervisor 5 Name: First Last Employed From 5: Date Format: MM slash DD slash YYYY Employed To 5: Date Format: MM slash DD slash YYYY If still employed here, don't fill in the date.Your job title 5:Work Performed 5:Hourly Rate/Salary to Start 5:Hourly Rate/Salary Final 5:Section BreakSpecial Skills & Qualifications*Summarize special skills and qualifications acquired from employment or other experience such as specific office skills, machines used, etc. Veteran of the U.S. Military service?YesNoIf Yes, Branch:*List professional, trade, business or civic activities and offices held. (You may exclude those which indicate race, color, religion, sex or national origin):Give name, address and telephone number of three references who are not related to you and are not previous employees.*NameAddressTelephone #How do you know them? Section BreakEducationPlease provide a list of schools attended starting with elementary, high, college/university, and graduate/professional or technical training.*School NameYears CompletedDiploma/DegreeMajor/Course of Study Applicant's Statement I understand this application is considered current for 90 days. If I want to be considered for employment after that time, I must renew my application by resubmitting this form. 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. I understand that this application is not and is not intended to be a contract of employment. I further understand said background check may also involve the Company's obtaining an investigative consumer report on me which may cover such areas as my character, general reputation and mode of living. 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 Company.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
