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Important Notice: If you need assistance in completing this application, please contact a member of our management team. Applicants should be extremely careful as they complete this application.

We are an equal opportunity employer and do not discriminate against otherwise qualified applicants on the basis of race, color, religion, national origin, age, sex, veteran status, disability, or any other basis prohibited by federal, state or local law. In accordance with Americans with Disabilities Act, it is our policy to provide reasonable accommodation upon request during the application process to eligible applicants in order that they may be given a full and fair opportunity to be considered for employment. Please answer all questions and print clearly. Resumes are not a substitute for a completed application.

Please select which location you would like to apply to:^*

Personal Information

Name^*

Address^*

Phone^*

Cell Phone

Email^*

Are you able at the time of employment to submit verification of your legal right to work in the U.S.?^*

(Verification and completion of Form I-9 must be submitted no later than three business days after date of hire.)

Which type of employment is desired?^*
Full Time
Part Time
Seasonal

Days and hours available^*

Date you can start employment^*

Desired salary range

Are you willing to work overtime?^*

Are you under the age of 18?^*

(If yes, you must meet state-required standards.)

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Education Background

High School

Name and location

Graduate?

Years Completed

Degree/Major

College

Name and location

Graduate?

Years Completed

Degree/Major

Other

Name and location

Graduate?

Years Completed

Degree/Major

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

Personal References

Please enter at least 3 references

Name^*

Years Known^*

Relationship^*

Phone^*

Name^*

Years Known^*

Relationship^*

Phone^*

Name^*

Years Known^*

Relationship^*

Phone^*

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Employment History

Have you ever been terminated or asked to leave any job?^*

Previous Employer #1

Employer Name^*

Type of Business^*

Address

Employer Phone

Dates Employed^*

Start Date

End Date

Job Title

Wages^*

Starting

Ending

Supervisor's Name

May We Contact?

Reason for leaving

Summarize the nature of work performed and job responsibilities

Previous Employer #2

Employer Name

Type of Business

Address

Employer Phone

Dates Employed

Start Date

End Date

Job Title

Wages

Starting

Ending

Supervisor's Name

May We Contact?

Reason for leaving

Summarize the nature of work performed and job responsibilities

Previous Employer #3

Employer Name

Type of Business

Address

Employer Phone

Dates Employed

Start Date

End Date

Job Title

Wages

Starting

Ending

Supervisor's Name

May We Contact?

Reason for leaving

Summarize the nature of work performed and job responsibilities

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Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer’s service, whenever it is discovered.

I understand this employer may utilize a sophisticated and detailed background and pre-employment investigation process.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, or in a resumé or job interview. I hereby waive and release any and all rights and claims I may have regarding: the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process; and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specific period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I acknowledge and agree that if at any time during the hiring process or during my employment I am subjected to any type of suspected discrimination or harassment or any other treatment which I believe to be unfair or improper, I will contact a member of the management team immediately to obtain assistance in the resolution of such matters.

Please read the above applicant statement.^*

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Waiver of Jury Trial and Class/Collective Actions

I understand and agree that by signing and submitting this employment application for consideration, I am waiving my right to have a jury trial to resolve any lawsuit I may ever bring against the Company to the extent permitted by law. Any lawsuit that I may bring against the Company will be tried to a judge without a jury. I also understand and agree that I am waiving my right to participate as a member in a class or collective action lawsuit and/or act as a representative of a class of similarly situated individuals in any lawsuit against the Company.

Please read the above applicant statement.^*

I certify that I have read, fully understand and accept all terms of the foregoing Waiver of Jury Trial and Class/Collective Actions Statement.

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