Employment Application

Name:

First Name

Last Name

Address:

Email:

Phone

(###)

###

####

Position applying for:

Date Available

YYYY

Salary Desired

Work History (list current/past three employers)

Provide a brief description on how you would be an asset to our company:

Are you authorized to work in the US?

Yes

Have you ever been convicted of a felony?

Yes

SOCIAL MEDIA ACCOUNT NAMES

REFERRED BY:

Date of Birth

Acknowledgment & Authorization

I HEREBY UNDERSTAND AND ACKNOWLEDGE THAT, IF HIRED, MY EMPLOYMENT RELATIONSHIP WITH THIS ORGANIZATION WOULD BE OF AN“AT WILL” NATURE, WHICH MEANS THAT THE EMPLOYEE MAY RESIGN AT ANY TIME AND THE EMPLOYER MAY DISCHARGE EMPLOYEE AT ANY TIME AND FOR ANY OR NO REASON. IT IS FURTHER UNDERSTOOD THAT THIS “AT WILL” EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED BY ANY WRITTEN DOCUMENT OR BY CONDUCT UNLESS SUCH CHANGE IS SPECIFICALLY ACKNOWLEDGED IN WRITING BY AN AUTHORIZED EXECUTIVE OF THIS ORGANIZATION.

In the event of employment, I understand that I will be hired on a AS NEEDED basis. Giving false or misleading information in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. By clicking SUBMIT you have read and agree to these terms.

Employment Application

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