EMPLOYMENT APPLICATION
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ALL POTENTIAL EMPLOYEES ARE EVALUATED WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER,
NATIONAL ORIGIN, AGE, MARITAL OR VETERAN STATUS, THE PRESENCE OF A NON-JOB RELATED
HANDICAP OR ANY OTHER LEGALLY PROTECTED STATUS.
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Position Sought:
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Location:
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How did you learn about the position?
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Your Name:
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Your Address:
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Your City:
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Your State:
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ZIP:
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Home Phone:
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Cell Phone:
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Other Phone:
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Drivers License # /State:
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Date Of Birth:
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Email Address:
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On what date would you be available for work?
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Desired Wage/Salary
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per
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Are you a U.S. citizen, or are you otherwise authorized to work in the U.S. without
any restriction?
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Yes
No
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Have you ever been convicted of a felony?
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Yes
No
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If yes, please describe circumstances:
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Have you ever been involuntarily terminated or asked to resign from any position
of employment?
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Yes
No
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If yes, please describe circumstances:
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If selected for employment, are you willing to submit to a pre-employment drug screening
test?
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Yes
No
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EDUCATION
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Other training, Certifications, or Licenses held:
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List other information pertinent to the employment you are seeking:
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EMPLOYMENT
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Address
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City
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State
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Zip
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Phone
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Supervisor Name
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AVAILABILITY For New Position
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Acknowledgment & Authorization
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I certify that answers given herein are true and complete to the best of my knowledge.
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I authorize investigation of all statements contained in this application for employment
as may be necessary in arriving at an employment decision.
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This application for employment shall be considered active for a period of time
not to exceed 60days. Any applicant wishing to be considered for employment beyond
this time period should inquire as to whether or not applications are being accepted
at that time.
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I hereby understand and acknowledge that I would be required to sign a "Commitment
Contract" not exceeding a time period of 24 months, starting on the first day of
employment. I also understand that in the event of employment, I will be "Bound
by this Contract"
from leaving the organization and the position that I am being employed for, for
the full term of the "Contract period" or as decided by
the Manager/Supervisor.
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I hereby understand and acknowledge that, unless otherwise defined by applicable
law, any employment relationship with this organization is of a "Contract Binding"
nature, which means that the Employee may not resign until the "Contract Period"
has elapsed and that the Employer may discharge Employee at any time with or without
cause. It is further understood that this "Contract Binding" employment relationship
may not be changed by any written document or by conduct unless such change is specifically
acknowledged in writing by any authorized executive of this organization.
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I also hereby acknowledge and understand that wages may be withheld and training
costs may be assessed to me in the event of voluntary termination of employment
within 6 months after completion of training.
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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 and agree to
having received the "Job Responsibility Checklist" & "Sanitary procedures training"
and take full responsibility in the event of any state authority issuing me a citation
and or fines arising due to my negligent sanitary procedures.
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I agree
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