Apply Here Name(required) Email(required) Phone #(required) Address(required) Position Applied For(required) Salary Desired Hours Preferred(required) Full-time Part-time How did you hear about us?(required) Website Social Media Newspaper Radio Mom Family Member School College Career Fair Employee Referral Friend Have you interviewed with the Company or its affiliates before?(required) Yes No If yes to above, list date(s), job title(s), and location(s)(required) Have you ever been employed by the Company or its affiliates before?(required) Yes No If yes to above, list date(s), job title(s), and location(s)(required) Do you have any relatives employed by the Company or its affiliates?(required) Yes No If yes to above, list date(s), job title(s), and location(s) Are you at least 18 years old?(required) Yes No If you are under 18, do you have a work permit? Highest Grade Completed(required) Some High School High School Diploma Some College Associate Degree Bachelor Degree Masters Degree High School Name(required) High School Degree Earned College/University Name College/University Degree Earned List Any Professional Designations List Any Special Knowledge, Skills or Qualifications(required) Computer Skills (Hardware/Software)(required) Employment History Past or Current Employer Name/Business(required) Employed From (xx/xx/xxx)-(xx/xx/xxxx)(required) Starting and Ending Salary(required) Past Job Title(required) Reason For Leaving(required) Duties/Responsibilites (required) Past Supervisor Name & Phone #(required) May we contact your current employer for references?(required) Yes No If hired, will you be able to work overtime?(required) Yes No Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accomodation?(required) Yes No Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which have not been annulled. expunged or seals by court? (A yes response does not automatically disqualify your application) A criminal background check including but not limited to a Limited Criminal History, Registered Sex Offender and BMV check may be conducted by the Company.(required) Yes No Do you have a valid Driver's License?(required) Yes No Do you have reliable transportation?(required) Yes No Do you have adequate car insurance?(required) Yes No Can you lift at least 50 lbs?(required) Yes No The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery. I authorize the Company to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to the Company and will hold the Company and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize the Company to obtain any credit and consumer check. I understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired, my employment will be terminable at will and may be terminated by me or the Company at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing. If employed, I will be required to provide original documents that verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9. Upon submission I hereby acknowledge that I have read and agree to the above statements.