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Employment Application

Date: 2019-05-19 01:40:42
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
Addresses
Street City State Zip Code
Current Address
Prior Address
Education
School Attended City State Diploma Degree/Cert. Area of Study
High School GED
Undergrad School
Grad School
Other School
Employment Information
Date You Can Start Calendar (yyyy-mm-dd) Desired Salary: $
Do You Prefer Can you work  Weekends
 Evenings 		Available: M Tu W Th F Sa Su
Are you available for shift work? 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?
If you are under 18 years of age, can you provide required proof of your eligibility to work?
2. Have you worked for this business before?
If yes, please provide dates and locations.
Employment History
Are you currently employed?
May we contact your present employer?
Most Recent Employer Prior Employer Prior Employer
Employer
City
State
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Phone
Position Held
From (m/yyyy)
To (m/yyyy)
Pay upon leaving
Supervisor
Duties
Reason For Leaving
Resume (Text Version)
Copy and Paste a text version of your resume here.
Upload File
Attach a file to your application submission (Permitted File Types: doc,docx,pdf,txt - Max file size: 1045876 bytes)
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