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Pursuant to federal law, all applicants, upon being made an offer of employment, must produce documents, which are specified by the federal government, establishing their identity and authorization for employment in the United States. These documents must be produced no later than 72 hours after commencement of employment. You also will be required to complete Form I-9 (issued by the federal government) verifying, under oath, your employment authorization and identity.
Education
Highschool
College 1
College 2
Graduate Degree
Trade, Business, or Correspondence School
Other
*All persons have the opportunity to be considered for employment without regard to their race color religion or creed, sex, age, national origin or ancestry, citizenship, veteran status, physical or mental disability, genetic predisposition or carrier status, marital status, sexual orientation, or any other personal characteristic protected by federal, state or local law.
Employment History
List Last Four Employers, Starting With Your Last Position
Position 1 (Most recent)
Position 2
Position 3
Position 4
References
Give the Names of Three (3), Work-Related References (Please do not use relatives as references).
Reference 1
Reference 2
Reference 3
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand whether in the pre-employment stage or if employed, falsified statements and/or omissions on this application, in interviews, on any documents or at any time orally and/or written during my employment, may be grounds for non-consideration for employment or dismissal from employment, at any time. Additionally, I understand that this application and all pre-employment and supporting documents must be completed in their entirety in order to be considered for employment, including designating “n/a” for when a question is inapplicable.
I authorize investigation of all statements contained herein. I also authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal and otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
I understand that this application is not a contract or offer of employment. I understand that no representation, whether oral or written, by any representative or agent of the Company can constitute a contract of employment. If hired, I agree to abide by all of the Company’s rules and regulations. I understand that if employed, my employment is on an at-will basis. I am free to terminate my employment at any time for any reason. Similarly, the Company is free to terminate our employment relationship at any time without cause or notice.
I further 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.