Employment Application

Equal Access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.

Employment Application

We are an Equal Opportunity Employer
Applications are considered for all positions without regard to race, color, religion, sex, national origion, disability, age (40 + older), ancestry, military status, genetic information or any other characteristic protected by applicable law.


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A conviction record will not necessarily be a bar to employment, and factors such as the timing of the offense, the seriousness and nature of the violation, and the nature of the job for which you are applying will be taken into account by the employer.

Education

References

List refences who have known you at least one year and who are not relatives or former employers.

Previous Employment

(Provide all previous employment with most recent first.)

Employer #1
Employer Name Telephone
Dates Employed To
Ending Rate of Pay($) Address
City State

Why did you leave?

Nature of Duties:

Employer #2
Employer Name Telephone
Dates Employed To
Ending Rate of Pay($) Address
City State

Reason for Leaving:

Nature of Duties:

Employer #3
Employer Name Telephone
Dates Employed To
Ending Rate of Pay($) Address
City State

Reason for Leaving:

Nature of Duties:

I understand that this application does not constitute an employment contract or an offer for employment. I further understand that if I am offered a position of employment, my employment will be "at will", and either I or the company may terminate the employment at any time for any reason with or without cause and with or without notice. I also understand that no individual representative of the company, other than the president in a writing specific to me and signed by the company president and me, may offer me an individual contract of employment. I understand that I must at all times abide by the companys rules and regulations and I agree to do so if employed.

I authorize the investigation of all statements contained herein and authorize the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I further release and agree to hold harmless the company and all parties providing information from all liability for any claim or damage that may result from furnishing such information to you.

I certify that the information I have given on this application is true and complete to the best of my knowledge and belief. I understand that any false information provided on this application, at the time of any interview(s), or on any company document may result in my immediate discharge.

In consideration of the employers review of my application, I agree that any claim or lawsuit arising out of my employment or my application for employment wit hthe meployer must be filed no more than six (6) months after the date of employment action that is the subject of the claim or lawsuit. While I understand that the statue of limitations for claims arising out of an employment action may be longer than six (6) months, I agree to be bound by the six (6) month period of limitations set forth herein and I WAIVE ANY STATUE OF LIMITATIONS TO THE CONTRARY.