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Employment Application

Applicants may be tested for illegal drugs.

* Required

Present Address

Contact Information

Work Information

Type of Employment Desired
Days / Hours Available for Work *


School Name Location Number of Years Completed Major or Degree Achieved
High School
Business or Trade School
Professional School

Criminal History

Have you ever been convicted of a crime?        

Note: The existence of a conviction will not necessarily preclude you from employment; the nature of the crime and its relationship to the position applied for, the degree of rehabilitation of the applicant and the time elapsed since the crime or release from confinement will all be considered.

Driving Information

Select any of the following driver's license classifications that you may possess.





Please list two references other than relatives or previous employers.

Personal Qualifications

Military Background

Have you ever served in the armed forces?        
Are you now a member of the National Guard?        

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Employment Dates:

Pay / Salary:

Employment Dates:
Pay / Salary:

Employment Dates:
Pay / Salary:

Employment Dates:
Pay / Salary:

May we contact your present employer?        
Are you completing this application for another individual?        

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 applicants are being accepted at that 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 my 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.

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