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EMPLOYMENT APPLICATION
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of sex, marital status, race, color, age, creed, national origin, sexual orientation, military service membership, ancestry, religion, height, weight, use of a guide or support animal because of blindness, deafness or physical handicap, or the presence of disabilities. A felony conviction will not necessarily bar an applicant from employment. Additional testing of job related skills and for the presence of drugs in your body may be required prior to employment. After an offer of employment, and prior to reporting work, you may be required to submit to a medical review. Depending on company policy and the needs of the job, you will be required to complete a medical history form and may be required to be examined by a medical professional designated by the company.
Email address
PERSONAL INFORMATION
Name - First & Last
Your answer
Address
Your answer
Phone Number
Your answer
Birthdate
MM
/
DD
/
YYYY
Are you a citizen of the United States?
If no, are you authorized to work in the U.S.?
Have you ever been convicted of a felony?
If yes, please explain.
Your answer
Have you worked for this company before?
If Yes, when?
Your answer
Referred By
Your answer
Military Service
Branch
Your answer
Rank at Discharge
Your answer
Date of Discharge
MM
/
DD
/
YYYY
Type of Discharge
Your answer
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