APPLICATION FOR EMPLOYMENT

Name *
Name
Telephone *
Telephone
Address *
Address
$
Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.) *
Are you capable of lifting and carrying up to 40lbs?
Have you ever been convicted of a felony? (This will not necessarily affect your application.) *
(School Name & Location, Year, Major/Degree)
Company Name
Company Phone Number *
Company Phone Number
$
Date Started *
Date Started
$
Date Ended *
Date Ended
May We Contact? *
Company Phone Number
Company Phone Number
$
Date Started
Date Started
Date Ended
Date Ended
$
May We Contact?
Company Phone Number
Company Phone Number
$
Date Started
Date Started
Date Ended
Date Ended
$
May We Contact?
IMPORTANT *
I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history. I understand that employment at this company is "at will," which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis.