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Position Information
Position of Interest:
*
Customer Service
Sales
Shipper/Receiver
Production Assistant
Graphic Artist
Marketing
Screen Printer
Desired Start Date
*
Check all that you are willing to work
*
Full Time
Part Time
Days
Mornings
Afternoons
Evenings
Weekends
Are you authorized to work in the U.S. on an unrestricted basis?
*
Yes
No
Have you ever been convicted of a felony?
*
(Convictions will not necessarily disqualify an applicant for employment.)
Yes
No
If yes, explain:
*
Have you been told the essential functions of the job or have you viewed a copy of the job description listing the essential functions of the job?
*
Yes
No
Can you preform these essential functions of the job with or without reasonable accommodation?
*
Yes
No
Qualifications
Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.
Special Skills
List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.)
References
Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three professional references, then list personal, unrelated references.
Reference #1
*
Name
Relation
Phone Number
Reference #2
*
Name
Relation
Phone Number
Reference #3
*
Name
Relation
Phone Number
Work History
Start with your present or most recent employment and work back. (Include paid and unpaid positions.)
Job #1
*
Title
Start Date - End Date
Company Name
Supervisor's Name
Location
Duties and Responsibilities
Reason for Leaving
Salary
May we contact your present employer?
*
Yes
No
Job #2
Title
Start Date - End Date
Company Name
Supervisor's Name
Location
Duties and Responsibilities
Reason for Leaving
Salary
Job #3
Title
Start Date - End Date
Company Name
Supervisor's Name
Location
Duties and Responsibilities
Reason for Leaving
Salary
*
I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application.
*
I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.
Signature
*
Date
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Date Format: MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.
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