Application for Employment

Legal Name: __________________________________________
Address: ______________________________________________________________________
City:__________________ State:__________________________ Zip:_____________________
Home Phone: ________________________Cell Phone:_____________________________
Date of Birth: _______________________Age as of application: __________________
Social Security Number: _________________________________
Position Applied for: ____________________________________
Shifts Applied for:_______________________________________
Previous Employment:
1)_______________________________________________From _______To_______
2)_______________________________________________From _______To_______
3)_______________________________________________From _______To_______
Have you ever been convicted of a crime? ________ If yes please explain:
Emergency Contact person: __________________________ Phone: ________________ 

I certify that the above information is correct and I understand that if employed any false statement on this application may result in my dismissal. I further understand that this application is not and is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me. I understand that my employment is at will and can be terminated by either party with or without notice, at any time, for any reason. You are hereby authorized to make any investigation of my personal history including but not limited to a criminal background check. Further I understand that possession of or use of any illegal drugs and any illegal sexual activity will be cause for immediate dismissal without benefit of warning.

Signature: __________________________________________ Date: _____________

Important