Employment Application

We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion, and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, or physical or mental disability.

First Name Last Name Address City State Zip Phone Email

General Infomation

Are you able to perform the essential job functions of the position for wich you are applying wiht or without reasonable accommodatons?

Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to preform in the position for which you are applying.)

If Yes, explain

Education

Education Completed

High School Attended High School Graduated Year High School Average Grade College Attended College Graduated Year College Degree of Study Any Academic Honors or Awards

Skills

Please list any skills you have that are appropriate for the position you are applying for. Are you willing to work Rotating Shifts

Are you willing to work Overtime

Are you willing to work Saturdays

Are you willing to work Sunday

Position you are applying for Salary Requirements State fully why you believe you are qualified for this position. Interests / Accomplishments You may wish to list significant experience, interests, and accomplishments gained while working as a volunteer or as a hobbyist that may be useful in the position you are seeking. Names or organizations designating religion, race, etc. need not be mentioned.

Employment History

Starting with your PRESENT or MOST RECENT EMPLOYER list in consecutive order ALL EMPLOYMENT for at least the past three employers.

If currently employed, may we contact your employer? Yes No

Company Address City State Zip Manager Position Job Duties Reason for Leaving Employed From/To Date

Company Address City State Zip Manager Position Job Duties Reason for Leaving Empoyed From/To Date

READ CAREFULLY: I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references 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 all parties from any liability for any damage that may result from furnishing same to you.