Employment Opportunities
Fields marked with "
*
" Are Required!
* Name:
* Phone:
* Address:
Alt.
Phone:
* Email:
U. S. Citizen?
Yes
No
Convicted
of a felony in last 7 years?
Yes
No
Briefly Explain:
* Position interested in:
If employed and under 18, can you furnish a work permit?
Yes
No
If you are under 18 please enter your age?
Have you filed an application with this company before?
Yes
No
Were you previously employed with?
Yes
No
Do you have any friends or relatives who work with us?
Yes
No
If yes, please list their names?
On what date would you be available to work?
Please indicate the times you are available to work:
Mon
Tue
Wed
Thu
Fri
Sat
Sun
6AM-10AM
10AM-1PM
1PM-4PM
4PM-7PM
7PM-10PM
Are you able to work?
Part Time
Full Time
Are you employed now?
Yes
No
If so, may we contact your present employer?
Yes
No
Do you have a car available for use?
Yes
No
Are you prevented from lawfully being employed in this country because of Visa or Immigrant status?
Yes
No
Are you a veteran of the U.S. Military Service?
Yes
No
If so, which branch?
In case of emergency, who should we contact?
Name
Home Phone
Work Phone
Education
Elementary
High School
Years Completed:
4
5
6
7
8
9
10
11
12
Name of School:
College
Graduate
1
2
3
4
1
2
3
4
Diploma / Degree?
Yes
No
Skills/Employment Summary:
Employed From
/To (Dates)
Employer Name, Phone Number, and
a brief summary of your duties
Additional Skills/Experience:
We offer Equal Employment Opportunity to all based on individual merit and do not discriminate on the basis of race, color, religion, national origin, sex, marital or veteran status, age, handicap, height, weight unless required to do so by law or bona fide occupational qualification. The questions on this pre-application are intended to be non-discriminatory in nature and applicants are not required to submit any information which could be used for discriminatory purposes.
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