Application for Employment

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

Applicant Information

Employment Information

Position Applied For*
Employment Type*

Are you able to meet attendance requirements?*
Do you have any objection to working overtime if necessary?*
Can you travel if required by this position?*
Have you ever been previously employed by our organization?*
Can you submit proof of legal employment authorization and identity?*
Are you under the age of 18?*
Select
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Upon offer of employment are you able to complete a drug test and background check as a condition of employment?*

A conviction will not automatically bar employment.

Employment History

Please provide all employment information for your past 4 employers, starting with the most recent.

Add Employer 1?*
Are you currently employed here?*

Add Employer 2?*

Add Employer 3?*

Add Employer 4?*

Educational History

Did you graduate?*

Other Skills & Qualifications

Any job-related training, skills, licenses, certificates, and/or other qualifications.

References

Please list three references, not including relatives or employers.

Add Reference 1?*
Add Reference 2?*
Add Reference 3?*

Agreement & Signature

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

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