Employment Application

How did you hear about us?

Please explain your answer above:
 Position(s) you are applying for:  *  

Upload Your Resume

If available, please upload your resume in PDF (.pdf) or Microsoft Word (.doc) format.

Current Resume (5 MB max):
* Click on the UPLOAD button to upload your resume.

Applicant Information

 Full Name:  *    
 Email:  *       
 Cell Phone#:  *       
Format: 000-000-0000
 Home Phone#:    
Format: 000-000-0000
 Address Line 1:  *  
Address Line 2:
 City / State / Zip:  *  

Important Professional Information

List any professional, trade, business or civic activities and offices held. You may exclude membership that would reveal gender, race, religion, national origin, ancestry, age, disability or any other protected status.

List any languages other than English that you can speak, read or write that could be of benefit to the position applied for:


* Describe any formal job training, skills, and/or certifications you possess:  

* What do you believe are the most unique features of your work history? If you are hired, what value would you add to our company?  

Additional Information

If hired, can you provide proof of US citizenship or proof of your legal right to work in the US? *   
If hired, do you have a reliable means of transportation to and from work? *   
If hired, would you be able to travel or work overtime as needed? *   
Have you ever been convicted of a felony or misdemeanor? *  
If yes, please explain:

*A criminal record does not constitute an automatic bar to employment and will be considered only as it substantially relates to the job.

Certification, Acknowledgement, and Consent

*Please read each statement closely and initial each acknowledging your understanding.

* Equal Employment Opportunity Statement: This company is committed to the principles of equal employment opportunity and is committed to make employment decisions based on merit. We are committed to complying with all Federal, State and local laws providing for equal employment opportunities, as well as all laws related to terms and conditions of employment. The Company desires to maintain a work environment that is free of sexual harassment and discrimination due to race, religion, color, national origin, physical or mental disability, age or any other status protected by Federal, State or local laws. The Company will make reasonable efforts to accommodate those physical or mental limitations of an otherwise qualified employee unless undue hardship would result for the company.

* Discrimination and Sexual Harassment Policy Statement: This company will not tolerate any form of unlawful discrimination, including sexual harassment. Any employee who engages in unlawful discrimination or sexual harassment will be subject to appropriate discipline, up to and including termination. Prohibited sexual harassment is defined as follows: Unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature constitutes sexual harassment when (1) submission to such conduct is made whether explicitly or implicitly a term or condition of an individual’s employment; (2) Submission to or action of such conduct by an individual is used as the basis for employment decisions affecting such individuals; or (3) Such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile or offensive work environment.

* Complete and Accurate Information: I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission or misstatement of material fact on this application, or any other document used to secure employment, shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

* At-Will Employment: I understand and agree that if I am employed, my employment will be “at-will”, which means that the Company may terminate the employment relationship at any time, with our without cause and with or without notice. Likewise, the Company will respect my right to terminate my employment at any time, with or without cause and with or without notice. I further understand that any prior representation, whether expressed or implied to the contrary is hereby superseded and that no promise or representation contrary to the foregoing is binding on the Company unless made in writing and signed by the Company’s president.

* Company Obligation: I understand and agree that the Company’s acceptance of this job application does not mean that a position for which I am qualified is open (unless specifically posted) or that the company has agreed to hire me. I understand that the Company is under no obligation to hire me as the result of accepting this completed application.

I have read and understand the above policy statements and
agree to be bound by them if employed by the company. * 

I certify that the information I have provided is true and complete. I understand that if I have given any false information or omitted any material fact, I may be disqualified from employment or, if hired, may be discharged from employment upon discovery of the false information and/or omission of material facts. * 

Digital Signature:  *     Submission Date:  *    xx/xx/20xx