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Employment Application

Applicant Information

If hired, can you provide evidence of legal eligibility to work in the U.S.? 
Any offer of employment is conditioned upon completing form I-9 and providing the appropriate documents for identity and work authorization.

Are you over the age of 18? 
If under 18 years of age, you will be required to submit a birth certificate or work certificate as required by state or federal law.

Are you presently enrolled in school? 
Have you served in the Military? 
Do you have a valid drivers license? 
Is your driving record in good standing? 
Have you ever been convicted of a felony? 
Do you consent to a pre-employment drug test? 

Your Availability For Work

Total hours per week you are available to work: 
Do you have reliable transportation? 

Three References

Provide Three References Who Are Not Family Members, Who We May Contact

Your Employment History

List names of employers with present or last employer listed first.
May we contact current employers before you are offered a position? 

Dates of Employment (From - To) 
Hourly pay or salary:

Dates of Employment (From - To) 
Hourly pay or salary:

Dates of Employment (From - To) 
Hourly pay or salary:


I certify that all of the information provided in this employment application is true and complete to the best of my knowledge, and J authorize investigation of all statements contained in this application, including a criminal background, credit history check, and drug test, as applicable, I understand that any false or incomplete information may disqualify me from further consideration for employment and may result in my immediate discharge if discovered at a later date.

I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer, past employers, and other organizations to provide information concerning my previous employment and other relevant information that may be useful in making a hiring decision. 1 release such persons and organizations from any legal liability in making such statements.

I have read, understand, and agree to the above statements.

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