Application for Employment

Legal Name*Required

First Last

Phone Number*Required

Alternate Phone

Your Email Address*Required

Enter Email Confirm Email

Address*Required

Street Address City State ZIP / Postal Code Country

How long have you been at present address?

Are you 18 years of age or older?*Required

Yes

No

Do you have a legal work certificate?*Required

Yes

No

What type of employment is desired?*Required

Full-Time

Part-Time

Other

Are you willing to work overtime?

Yes

No

Are you legally eligible to work in the United States?*Required

Yes

No

If not, then what steps must be taken for you to begin employment?*Required

More Information

Have you ever been terminated from a job?*Required

This includes resignations that were mutually agreed upon.

Yes

No

If yes, how many times?*Required

Please explain the circumstances surrounding each termination.*Required

Tell Us About Yourself*Required

Briefly describe your qualifications for this position and any special skills or experience that you possess.

List any professional or occupational registration, licensure or certification you currently hold which many be applicable to the position for which you are applying.

Also, please indicate whether you have had any related professional credentials revoked or terminated.

Work-Related References

List the names of additional work-related references we may contact who have worked with you in the past. If you lack work-experience, please list any school or volunteer-related references.

Name

Position

Company

Work Relationship

Telephone (or Email)

Personal References

List the names of additional work-related references we may contact who have worked with you in the past. If you lack work-experience, please list any school or volunteer-related references.

Name

Occupation

Company

Telephone (or Email)

Number of years known

Upload Your Resume

Note: We will only accept your resume if it is in .pdf, .doc or .docx format.

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 25 MB, Max. files: 3.

Applicant Certification (Please Read)*Required

I agree and understand

By submitting this application, you agree to the following terms:

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver license for the state in which I reside.

I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent
with applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I
understand that if a pre-employment (post-offer) unlawful drug and/or alcohol test is positive, the employment offer may be withdrawn where allowed by law. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state, and local law, may be subject to urinalysis or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that alcohol and/or drug testing may be a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state, and local law.

If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of Company property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property.

I UNDERSTAND THAT I HAVE NO EXPECTATION OF PRIVACY IN COMPANY PROPERTY.

I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement. I certify that all the information on this application, my résumé, or any supporting documents I may present during any interview is and will be true, complete and accurate, to the best of my
knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from further consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal, regardless of when such information is discovered. The Company considers this Application for Employment to be a part of the personnel record.

THIS COMPANY IS AN AT-WILL EMPLOYER WHERE ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. I UNDERSTAND THAT NO COMPANY EMPLOYEE OR REPRESENTATIVE HAS THE AUTHORITY TO ENTER INTO A CONTRACT REGARDING DURATION OF TERMS AND CONDITIONS OF EMPLOYMENT OTHER THAN THE PRESIDENT/CEO OF THE COMPANY AND THEN ONLY BY MEANS OF A WRITTEN CONTRACT SIGNED BY THE PRESIDENT/CEO.

I authorize the Company and/or its agents to confirm all statements contained in this application and/or résumé as it relates to the position I am seeking, to the extent permitted by federal, state, or local law. Federal law and some states require a separate disclosure and consent when obtaining background reports from a consumer reporting agency. I understand I will be asked to complete any requisite consent forms for the background check which may be required by federal, state and/or local law. I agree to sign these forms and understand that my offer of employment may be conditional upon the background check.

I AUTHORIZE AND CONSENT TO, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY THIS EMPLOYER (INCLUDING ANY AND ALL PRIOR EMPLOYERS OF MINE) TO FURNISH INFORMATION REGARDING MY PREVIOUS EMPLOYMENT HISTORY AND/OR ANY OF THE ABOVE-MENTIONED INFORMATION.

I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company for seeking such information and all other persons, corporations, or organizations furnishing such information.

If hired by the Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company as required by the Immigration Reform and Control Act of 1986.

I also understand this Company employs only individuals who are legally eligible to work in the United States.

To the extent required by applicable law, the Company maintains a smoke-free workplace.

FEDERAL AND/OR STATE LAW MAY PROHIBIT THE USE OF LIE DETECTOR, POLYGRAPH OR SIMILAR TEST AS WELL. I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE. DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THE APPLICATION.

By clicking "submit," you agree to these terms and conditions where applicable, as set forth by legality in the state of Illinois.

Applicant Signature*Required
DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THE APPLIACATION. If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that the Company, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to Company personnel who need to know, the applicant, and the applicant's legal guardian.

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