Employment Application

    Personal Information

    Are you legally eligible for employment in the United States?
    Have you been convicted of a crime in the past ten years?
    Are you available for full time?
    If no, what hours?
    Do you have any experience or training in this field?
    If yes, describe:

    Education

    Highest grade completed




    If you did not complete high school, do you have an equivalency diploma?


    Did you attend college?



    List educational institutions in order (excluding high school):

    Name / Address Major / Specialty Dates Attended

    Employment History (starting with most recent)

    JOB #1

    JOB #2

    JOB #3

    Applicant's Signature

    Please read and understand this statement before signing:

    The information I have provided in this Application for Employment is true, correct and complete. False, incomplete or misinterpreted information of any kind will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment.

    I authorize the employer to contact and obtain information about me from previous employers, educational institutions and references I provided, and any other party necessary to verify the accuracy of the information I provided. To assist in the processing of my application, I waive all rights and claims I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate ,y employment request and all other person, corporations or organizations who provide information for this purpose.

    This application will expire in 30 days. After that date, unless otherwise notified, I understand that my status as an applicant will end. I may re-apply for employment in the future by completing a new application.

    This application is not an employment agreement. If I accept an offer of employment I understand I may resign at any time, and the employer may terminate my employment at any time, with or without cause and without prior notice, unless required by law. I understand that no one, other than an executive officer of the employer, has authority to enter into an employment agreement with terms contrary to the foregoing and then only in writing signed by such officer.

    I fully understand and accept all terms and conditions in the above statement.

    * Indicates Required Field.