Employment Application

Which position are you applying for?*
Are you willing to relocate?
When can you start?
Salary Requirements
Are you a citizen of the United States:*
If not, are you authorized to work in the U.S.:
Have you ever worked for this company:
If so, when?
Have you ever been convicted of a felony?*
If yes, explain:
Are you able to perform the functions of the job?*
If no, are there reasonable accommodations that can be made?
Name:*
Email Address*
Phone*
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Emergency Contact Number:*
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Emergency Contact Person:*
Relationship:
Attach a Copy of Your Resume*

NOTICE TO APPLICANTS
This Company complies with the Americans With Disabilities Act of 1990. During the interview process you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, all entering employees in the same job category will be subject to the same medical questionnaire and/or examination. All information will be kept confidential and in separate files.
Applicants accepted for employment should clearly understand that while we make an effort to provide steady, continuous work, we have no employment
contracts and we cannot guarantee the permanence of any position. Job tenure can be affected by many factors including business/economic conditions, changes in laws or Employer policies, conformity to our work rules, job performance, etc., and of course, employees may elect to leave of their own accord to seek other jobs.
We conduct our business with the highest possible degree of safety and efficiency. Because of this, the employer may require applicants for employment to undergo blood and/or urinalysis screening for drug or alcohol use as part of our pre-placement physical examination. In addition, all employees of the Employer are subject to random blood tests and/or urinalysis screening for drug or alcohol use.
APPLICANT’S STATEMENT
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of my background and all matters
contained in this application and hereby give the Employer permission to contact schools, previous employers, references, and all others, and hereby release the Employer from any liability as a result of such contact and release all such persons or companies or corporations supplying information from all liability for all damages on account of supplying such information. I understand that misrepresentations, omissions of facts or incomplete information requested in this application may remove me from further consideration for employment or, if employed by the Employer, may result in the termination of my employment. I agree to furnish such additional information and complete such examinations as may be required to complete this application. In consideration of my employment, I agree to conform to the rules and regulations of the Employer. I understand that my employment with the Employer is for no specific term, and that my employment, compensation, and benefits can be terminated, with or without cause, and with or without notice, at any time, for any reason, at the option of the employer or myself.
I further understand that no oral promise, Employer policy, custom, business practice or other procedure (including the Employer’s Employee Handbook or any personnel manuals) constitutes an employment contract or modification of the at-will employment relationship between the employer and me.
The contents of any Employee Handbook or personnel manuals, as well as other Employer policies and practices, are subject to change or modification by the
Employer, solely at its discretion, without notice.
I also understand that no manager, supervisor, or company representative(s) other then the Employer’s President, has any authority to enter into any employment agreement for any specified time period, or to make any oral or written agreement contrary to the foregoing.
I further understand that as part of the condition of my employment I may be required to sign and agree to a non-solicit/non-compete/confidentiality agreement.
I understand all notices to applicants above, and I agree to submit to testing for drug or alcohol use in accordance with the Employer’s policies.
This application will remain active for thirty (30) days. Any applicant wishing to be considered for employment beyond thirty (30) days should reapply.
This employer is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, sexual
orientation, religion, national origin, disability, veteran or marital status, or any other status or condition protected by applicant’s federal or state statutes, except
where a bona fide occupational qualification exists. Your opportunity for employment with the Employer depends solely upon your qualifications.

Agreement:*
Date:*