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Employment application

Employment Application


We are an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race, color, creed, religion, national origin, ancestry, alienage or citizenship status, age, disability, sex, sexual orientation, veteran status, genetic information or any other characteristic protected by applicable federal, state or local laws. We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please let us know.

General Information


Please note that all fields marked with an asterisk (*) are required

If you are under 18 years of age, do you have a work permit?

If yes selected, you will be custom-required to present a valid copy of the work permit at your interview.

Are you legally authorized to work in the U.S.? * (Please read below **)

** Pursuant to the immigration reform and control act of 1986, all applicants who are offered employment must produce documents establishing their identity and authorization for employment in the united states. These documents must be produced no later than seventy-two (72) hours after employment commences. In addition, all new hires will be custom-required to verify their employment authorization under oath by signing INS Form 1-9.

Employment Information


Employment time
Is there anything that would prevent you from working any day or time of the week or regularly working overtime?
Have you ever been employed by us?
Have you ever applied for employment with us?
Do you have any relatives working for us?

Educational History


Please note that all fields marked with an asterisk (*) are required

Employment History


Please enter all prior employers, beginning with your present or most recent employer. Complete all requested information in full. Do not include overtime, bonus, commissions, etc. In the base salary information. Please include as part of your employment history any verified work performed on a volunteer basis and / or work performed while in the military.


Is there any reason why we should not contact any current or former employer for a reference?

If you are a military veteran, please note any job-related training you received which would help you perform the duties of the position you are seeking:

Please indicate any job-related skills and qualifications you possess which would help you perform the duties of the position you are seeking:

Personal References


Please list the names, addresses and telephone numbers of three personal references who have knowledge of your capability to perform the duties of the position you are seeking. Please exclude relatives and former employers.


Applicant’s Statement

Please read carefully before clicking send.


I have read and fully understand the questions asked in this application. I certify that all of the answers I have given are true, accurate and complete. I understand that the omission and/or misrepresentation of any fact from or on this application or during any interview will result in immediate rejection of my application or if I am hired will be cause for immediate dismissal. Unless I noted otherwise, I authorize the Company to contact all my employment references, as well as the education institutions I have attended. I further authorize the Company to inquire about, investigate and obtain copies of any records which relate to me from my former employers and educational institutions to the extent permitted by applicable law. I hereby release the Company and all affiliated persons and entities, as well as any person or institution that provides the Company with any lawful information about me, from any and all liability whatsoever resulting from any such lawful inquiry, investigation or communication. I hereby consent to the inspection at any time, by Company officials, at the company’s expense, to reveal the presence of alcohol or drugs in my system (or upon failure to submit to any such test/search, to be terminated immediately). I agree to abide by all of the rules and regulations of the Company. I understand that nothing in this application shall constitute an offer, a contract or a guarantee of employment for a specific period of time. If hired, I understand that my employment may be terminated with or without cause and with or without notice at any time, at the will of the Company or me. In addition, I understand that the Company and all plan administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms and conditions of employment with or without notice. As a condition of my employment, I agree to the extent permitted by law to waive my right to a jury trial in any action or proceeding related to my employment or the termination of my employment with the Company. I am waiving my right to a jury trial voluntarily and knowingly, and free from coercion. I understand that any hiring decision is contingent upon my successful completion of all of the Company's lawful pre-employment checks. I agree to execute any consent forms necessary for the Company to conduct its lawful pre-employment checks.