Employment Application

WORK SCHEDULE AVAILABILITY:

Most positions begin after 5:00pm. Limited weekend hours occasionally available. Please indicate employment preference and hours available.

Please check the shift(s) that you would be interested in working:


SCHEDULE AVAILABILITY:







PERSONAL INFORMATION:

Equal access to programs, services and employment is available to all persons. Those applicants requiring accommodation to the application and/or interview process should contact a representative of the Personnel Department.

Referral Source:






If you are under 18, can you furnish a work permit?Ye


Have you filled out an application here before?


Have you ever been employed by our company?


Are you eligible for work in this county?


Have you been convicted of a felony in the last seven (7) years?


(Such conviction may be relevant if job related, but does not bar you from employment.)

EMPLOYMENT HISTORY:

List your last 4 employers - Please explain any gaps in your employment history.

Employer #1

Dates of Employment:
May We Contact For Reference?


Employer #2

Dates of Employment:
May We Contact For Reference?


Employer #3

Dates of Employment:
May We Contact For Reference?


Employer #4

Dates of Employment:
May We Contact For Reference?


EDUCATIONAL BACKGROUND:

List the last two schools you attended, starting with the most recent:

School #1:

School #2:

 

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed.

I give the employer the right to investigate all references and to secure additional information about me, if job-related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

The employer is an Equal Opportunity Employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by any local, state or federal law.

I understand that just as I am free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause, and without prior notice. I understand that no representative of this employer has any authority to make me any assurances to the contrary.

I understand it is the company's policy not to refuse to hire a qualified individual with a disability because of this person's need for an accommodation that would be required by the ADA.

I agree with the above statements: