Click on the respective links and download
the following forms. These forms are PDF files
and can be read via Adobe Acrobat.

Application For Employment
All RED text is a required field.
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.
Position(s) Applied For: Date:
How did You Learn About Us?
Advertisement (name of newspaper)
Employment Agency Radio Internet
Inquiry Relative Friend
Last Name: First Name: Middle Name:
Address  City State/province:
Zip/postal code:  Telephone: Email:
Best time to contact you at home is:   OR 
If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes No
Have you ever been convicted
of a felony? Have you ever been convicted of a misdemeanor involving dishonesty or theft?		 If Yes, explain Yes No
Have you ever filed an application with us before? If Yes, give date Yes No
Have you ever been employed with us before? If Yes, give date Yes No
Do any of your friends or relatives, other than spouse, work here? Yes No
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you prevented from lawfully becoming employed in
this country because of Visa or Immigration Status?		 Yes No
    Proof of citizenship or immigration status will be required upon employment.
Date available for work What is your desired salary range?
Are you available to work: Full-Time
     Part-Time
     Temporary Please indicate dates available
Are you currently on "lay-off" status and subject to recall? Yes No
Can you travel if a job requires it? Yes No
EMPLOYMENT EXPERIENCE
Start with your present or last job and fill out each section completely. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status.
1.
Employer:

Dates Employed
From    —    To

Address: City:
Telephone Numbers:


Starting — Final
Job Title: Supervisor:

Reason for leaving:
Work Performed
2.
Employer:

Dates Employed
From    —    To

Address: City:
Telephone Numbers:


Starting — Final
Job Title: Supervisor:

Reason for leaving:
Work Performed
3.
Employer:

Dates Employed
From    —    To

Address: City:
Telephone Numbers:


Starting — Final
Job Title: Supervisor:

Reason for leaving:
Work Performed
4.
Employer:

Dates Employed
From    —    To

Address: City:
Telephone Numbers:


Starting — Final
Job Title: Supervisor:

Reason for leaving:
Work Performed
List professional, trade, business, or civic activities and offices held.
You may exclude memberships which would reveal gender, race, religion, national origin, age,
ancestry, disability, or other protected status.
EDUCATION
  Course of Study No. of Years Completed Diploma / Degree
High School

Yes No
College Yes No
Graduate Professional Yes No
Describe any specialized training, apprenticeship, skills, and extra-curricular activities that might relate to the job.

Describe any job-related training received in the United States military.

Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience.
State any additional information you feel may be helpful to us in considering your application.
REFERENCES
1. Name Address Phone
2. Name Address Phone
3. Name Address Phone

APPLICANT'S STATEMENT
I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at this time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in any application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Yes, I agree
No, I do not agree
Agreement of Applicant*

Date:

* If any applicant is being considered for employment they will be asked to sign an original statement.
    
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given.

YES      NO