Job Opportunities If you are looking for employment opportunities, please fill out the online application. Contact Information Name * First Last * Last Email * Phone Number Address City State Zip Employment Information Date you can start Salary Availability Full Time Part Time Are you at least 18 years or older? Yes No Were you referred? Yes No Who referred you? Please check all hours you are available. Monday AM PM Tuesday AM PM Wednesday AM PM Thursday AM PM Friday AM PM Saturday AM PM Sunday AM PM Education High School Diploma or Degree Yes No College Diploma or Degree Yes No Other School Diploma or Degree Yes No Past Employment Present or Last Employer Date Hired Date Left Job Title Job Description Reason for leaving ---------------------- Previous Employer Date Hired Date Left Job Title Job Description Reason for leaving ---------------------- Previous Employer Date Hired Date Left Job Title Job Description Reason for leaving References Name Profession Relationship to Self Phone Number ---------------------- Name Profession Relationship to Self Phone Number ---------------------- Name Profession Relationship to Self Phone Number Authorization By chekcing "yes" you certify the information below. * Yes AUTHORIZATION "I CERTIFY THAT THE FACTS CONTAINED, IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AtJD UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FOR UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE." DRUG FREE WORKPLACE ALL EMPLOYMENT APPLICANTS AT THIS COMPANY MAY UNDERGO TESTING FOR THE PRESENCE OF ILLEGAL DRUGS OR OTHER SUBSTANCES AS A CONDITION OF HIRING. ANY APPLICANT WITH A CONFIRMED POSITIVE TEST RESULT WILL BE DENIED EMPLOYMENT. THIS COMPANY WILL NOT DISCRIMINATE AGAINST APPLICANTS FOR EMPLOYMENT BECAUSE OF PAST HISTORY OF DRUG ABUSE. THEREFORE, INDIVIDUALS WHO HAVE FAILED A PRE-EMPLOYMENT TEST MAY INITIATE ANOTHER INQUIRY WITH THE COMPANY AFTER A PERIOD OF NO LESS THAN SIX (6) MONTHS, BUT MUST PRESENT THEMSELVES DRUG FREE.
