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Employment Application
Date:
2021-01-23 20:37:33
THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT
but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a pre-employment drug screening and/or medical examination. This application will remain active for 3 years.
Personal Information
First Name*
Middle Name
Last Name*
Home Phone
Cell Phone
Email Address*
Addresses
Street
City
State
Zip Code
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Prior Address
Education
School Attended
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State
Diploma
Degree/Cert.
Area of Study
High School
No
Yes
GED
Undergrad School
No
Yes
Grad School
No
Yes
Other School
No
Yes
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Date You Can Start
(yyyy-mm-dd)
Desired Salary: $
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Full-Time
Part-Time
Either
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Evenings
Available:
M
Tu
W
Th
F
Sa
Su
Are you available for shift work?
No
Yes
Not Available
Please answer all of the following questions.
1.
Are you at least 18 years of age and legally eligible to work for our company in the United States?
No
Yes
If you are under 18 years of age, can you provide required proof of your eligibility to work?
No
Yes
2.
Have you worked for this business before?
No
Yes
If yes, please provide dates and locations.
Employment History
Are you currently employed?
No
Yes
May we contact your present employer?
No
Yes
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Applicant Certification Agreement
1.
The information in this application is true and complete to the best of my knowledge. Any falsification, misrepresentation, or omission on this application can be cause for denial or termination of employment.
2.
If hired, my employment is voluntary, meaning that either party can employment at any time for any reason. Upon acceptance of employment if a position is offered, I agree to abide by all existing and future company rules and regulations. The company reserves the right to change any working agreement as deemed necessary.
3.
Any employment offer is contingent upon my providing proof of identity and eligibility to work the country of employ.
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Testimonials
The staff (I think it was Jason or James) spent almost two hours going above and beyond helping me and my mom with some oxygen concentrator issues. The staff was extremely caring, compassionate, and informative.
Customer
Apr 28, 2016
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