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Employment Application

Are you 21 years of age or older?
Do you have a valid driver's license?
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Do you have the legal right to work in the United States?

Proof of citizenship or immigration will be required upon employment. Form I-9 must be submitted, verified and completed no later than three business days after date of hire per the Immigration Reform and control Act of 1986.

Can you with or without reasonable accommodation perform the essential functions of this job?

 If you have any questions about the functions of the job, please ask the interviewer before answering this question.

You will be required to submit to a drug screen. Are you willing to do so?
Have you ever been convicted of a crime? Conviction will not necessarily disqualify an applicant from employment.

Education

Professional References

Employment History

Are you currently employed?

Employer 1

Important: Read Carefully

I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for rejection or immediate dismissal. Routine inquiry may be made during initial or subsequent processing which will provide applicable information concerning character, general reputation, personal characteristics, and mode of living. Upon request, additional information as to the nature and scope of the inquiry has been provided to me.

I understand that the use of this form does not indicate that there are positions open and does not in any way obligate the Company. If employed, I will comply with the Company's rules and regulations. Further, I understand and agree that my employment is for no definite period of time and may, regardless of the date of payment of my wages and salary, be terminated at any time, for any reason, without notice. No person other than the President of the Company may modify or amend the provisions stated herein.

I understand that my employment may be conditioned upon a health evaluation which may include a physical examination by a doctor selected by the Company. This health evaluation may also include a test for drugs and alcohol. By signing this application, I hereby agree to submit to such examinations and tests and release all persons and companies from any liability arising out of such examinations and tests.

I hereby authorize release of any information regarding any criminal convictions that may exist against me, and ask my former employer(s) and all other persons named herein who might have information concerning me to give any information regarding my former employment or any other information they may have regarding me whether or not the same is a matter of record, and I hereby release them and each of them from any liability for any damage whatsoever which I could or might claim because of such disclosure.

I certify that all statements made by me on this application are true and complete and understand that any provision of false or misleading employment information may result in a refusal to hire or, if discovered after commencement of employment, in discipline or discharge.

I hereby acknowledge that I have read and understand the above statement.