Job Application

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Name *
Address
If hired do you have a reliable means of transportation to get to work? *
Are you at least 18 years old? *
Expiration Date *
Are you legally eligible for employment in the U.S.? *
Have you been convicted of a crime? *

NOTE: The existence of a criminal record does not constitute an automatic bar to employment.

How did you find out about this job? *

Employment

What are you seeking? *
Are you willing to work:
Overtime? *
Weekends? *
Holidays? *
Have you ever worked for this organization before? *
Are you on layoff and subject to recall? *
Have you ever been discharged or asked to resign? *
If yes, indicate the name used for employment:
If applicable, please refer to the attached job description for the position for which you are applying. Are you able to perform all these tasks with or without reasonable accommodation? *

Education

Please indicate your highest level of education: *
If currently in high school, are you enrolled in a recognized co-op program?

Military Experience

Are you a veteran? *

Work History

Tell us about your previous employers using the fields below. To add an additional employer, use the "add another employer" button.

Employer
Address
Are you currently working for this employer?
May we contact all of the employers you've listed in this application? *

Reference Verification

Please choose one of your previous employers which you listed in this application. We will use this employer as a reference and may contact your supervisor to verify your work history with the employer.

Did you work overtime? *
Were you ever counseled about attendance or tardiness? *
Did you have performance review? *

Reference Verification

When we speak to your former supervisor, we will ask him or her to rate your performance with regard to the following categories. Please rate yourself in the following categories as you feel your former supervisor will rate you:

The degree to which you are willing to work harmoniously with others; the extent to which you conform to the policies of management.

The extent to which you can be depended upon to be available for work and do it properly; the degree to which you are reliable and trustworthy; the extent to which you are able to work scheduled days and times, as well as your willingness to work additional hours if needed.

The degree to which you act independently in new situations; the extent to which you see what needs to be done and do it without being told; the degree to which you do your best to be an outstanding employee.

The degree to which your work is free from errors and mistakes; the extent to which your work is accurate; the quality of your work in general.

The degree to which you relate to the customer’s needs and/or concerns.

The degree to which your previous employer was satisfied with your efforts and achievements, as well as your eligibility for rehire.

Did you resign from this position? *
Were you discharged? *
Were you laid-off? *
Were you ever disciplined on the job? *

If the job you are applying for requires a resumé, please upload your file below:

Signature

I authorize this company to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge. I specifically authorize and direct my current and former employers to supply employment-related information to this company and do hereby release my current and former employers from liability for providing information to this company. Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer. I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investigative report deemed necessary through various third-party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations. I hereby agree to submit to any drug test required, whether prior to my employment or if employed by this company at any time thereafter. If requested, I will take a post- job offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician.