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Application for Employment

Job Application

All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, severe/morbid obesity, medical condition, military/veteran status, genetic information, marital status, ethnicity, alienage or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring accommodation to complete the application and/or interview process should contact a management representative.

Personal Information

First
Last
Address
City
State/Province
Zip/Postal

Work History

Please list the names of your present or previous employers in chronological order with present or most recent employer listed first. Be sure to account for all periods of time. If self-employed, give firm name and supply business references.
From ~ To
May we contact

Section

Have you ever been involuntarily terminated or asked to resign from any job?

Education

Diploma / Degree

References

Please list three professional references of individuals who are not related to you.

General Information

1. Have you ever used another name?......
2. Is any additional information relative to name changes, use of an assumed name, or nickname necessary to enable a check on your work and educational record?.....
3. Have you ever worked for this company before?.....
4. Do you have friends and/or relatives working for this company?.........
6. Days / Hours available to work:
7. Are you available to work?......
Specify $/hour or $/month
9. If hired, would you have a reliable means of transportation to and from work?........
10. Can you travel if the position requires it? ......
11. Can you relocate if the position requires it? ......
12. Are you at least 18 years old? ......
Note: If under 18, hire is subject to verification that you are of minimum legal age.
13. If hired, can you present evidence of your identity and legal right to work in this country?......
14. Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation? ......
Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions.

Emergency Contact(s)

NOTIFICATION AND AGREEMENT

* PLEASE READ BEFORE SIGNING *

To: Any person, organization or agency having knowledge of my conduct or activities, including any past or present employer or supervisor thereof; or any dean, registrar, principal, counselor, instructor or other authorized person at a School (High School, College, University, Trade School, or other); or any doctor, hospital, clinic or sanitarium; or any department or agency of city, county, state, or federal government.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation.

I CERTIFY THAT ALL ANSWERS GIVEN BY ME IN THIS APPLICATION DOCUMENTATION ARE TRUE, ACCURATE AND COMPLETE, AND I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACT ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR H0W DISCOVERED.

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State or Local law.

If hired, I agree to abide by all the company rules and regulation, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the company or me. I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment. 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 or conditions of employment. No representative or agent of the company, has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the President, or to make any agreement contrary to the foregoing.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application (or any other accompanying or required documents) by me. I understand that any misrepresentations or omission of facts called for in this application is cause from dismissal. Further, I UNDERSTAND AND AGREE THAT ALL TERMS OF MY EMPLOYMENT WILL BE AS SPECIFIED IN MY HIRING LETTER WITHOUT ANY PRECONDITIONS.

I understand