Application

Personal Information

Are you over 18?
YesNo

Are you either a United States Citizen or an Alien authorized to work in the United States?

YesNo

Have you ever been convicted of plead guilty or no contest to any criminal offense? (Criminal convictions are not an automatic ban from employment but will only be considered in relation to specific job requirements)

YesNo

Education

Did you graduate High School? *
YesNo

If you didn't graduate do you have a GED? *
YesNo





Work Interest



Have you ever filed an application with our company before?
YesNo


Have you ever been interviewed by our company before?
YesNo

Please indicate the hours you would be available to work if asked:

Overtime
YesNo

Weekends
YesNo

Holiday
YesNo

Do you have your own reliable transportation?
YesNo
Do you have a valid driver's license?
YesNo




Do you have a clean driving record? YesNo

WORK HISTORY

Are you currently employed:
YesNo

May we inquire with your current employer?
YesNo

List the names of employers in consecutive, order with present or last employer listed first. Account for all periods including military services. If self‐employed, give firm name and supply additional references.











Have you ever been disciplined associated with theft? YesNo
Have you ever been terminated from employment? YesNo
Have you ever served in the military?YesNo

Reference

Reference

Reference

ADDITIONAL TERMS AND CONDITIONS OF EMPLOYMENT AFFIDAVIT

I certify that the answers given by me in the foregoing questions and statements on the employment application and/or during the employment interview process are true and correct without any consequential omissions of any kind whatsoever. I understand that any misleading or incorrect statements may render this application void and, if employed, would be cause for my termination. I further agree the Company shall not be liable in any respect if my employment is terminated because of falsity of statements, answers or omissions made by me in this application.

I understand that this application is designed for use with several types of jobs and some questions may not be considered applicable to the position for which I am applying.

I authorize the companies, schools, persons or entities given during the employment process, and the employer (if employed), while employed, or during internal investigations, as references or past employers or affiliations, to give any information regarding my employment, character, qualifications, certifications and licenses, and hereby release said companies, schools, persons or entities from all liability for any damage for issuing this information. A favorable result may be a condition of employment, commencement or continuation of any employment duties where elements are job related.

I understand that I may be required to have a medical examination and/or drug and alcohol test after an offer of employment has been made and prior to the commencement of my employment duties. A favorable result on the medical examination and/or drug and alcohol test would be a condition of my employment or commencement of any employment duties.

I realize that operating conditions may require me to work shifts or work hours scheduled other than the one for which I am applying and I agree to such scheduling change as directed by my supervisor or management.

I understand that my employment is not for a specified or definite term and that I may resign, or I may be discharged, at any time, for any reason, with or without good cause and with or without prior notice. I further understand that this policy cannot be changed or amended except by written agreement signed by me and by a corporate officer. I understand that this is an application for employment and that no employment contract is being offered.

I understand that only United States Citizens or aliens who are legally entitled to work in the United States are eligible for employment.

My employment shall be in accordance with the terms of this application, all safety and incident reporting rules, and all other Company rules and regulations. The Company shall have the right to amend, modify or revoke its rules and regulations at any time. I will familiarize myself promptly with such rules and regulations and will abide and be bound by the rules and regulations now or hereafter in effect.

I certify that as a part of the application process, I have been provided with a written job description or have had the opportunity to review and/or discuss the requirements of the position. I certify that I understand each requirement and that I am capable of meeting each and every requirement.