• Application for Employment

    This company practices equal employment opportunity. We do not discriminate in hiring or employment on the basis of race, color, religion, sex, national origin, age, disability, status as a disabled or Vietnam era veteran, or any other applicable protected class. This form is designed to secure information that is job related; no question in this application is intended to secure information that will be used for any unlawful or discriminatory purpose.



    (Begin with Current Employer)

    Note: All degrees listed below may require verification prior to employment.
  • High School

  • College

  • Other Schools


    (if applicable)

    Please provide at least three business or professional references, including two of your previous direct supervisors.


    Please read carefully before signing.
  • I certify that answers given herein are true and complete to the best of my knowledge.

    I authorize the references listed in this application, including personal and employment references, to provide you with all information pertinent to this application and I release all parties from liability for any damages that may result from the release of any information as a part of the employment verification process. I authorize the Company or its representatives to obtain a consumer report to conduct a check with any consumer reporting agency for employment evaluation only.

    I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the Company and myself for either employment or for the providing of any benefits. No promises regarding employment have been made to me, and I understand that no promise or guarantee is binding upon the Company unless made in writing by a company officer. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company, and that, if employed, my employment is at will and that I have the right to terminate my employment at any time for any reason and that the company retains the same right.

    I understand and agree that upon the event of employment, I will be expected to be candid and to cooperate fully with any and all investigative efforts undertaken by the Company to resolve any customer or monetary transactions or other work related matter.

    I understand and agree that in accordance with Federal Law, I must provide proof of identity and proof of eligibility to work in this country upon the event of employment.

    In the event of employment, I understand that I may not engage in any activities that constitute a conflict of interest between the Company and me. I understand that it is my responsibility to notify the President prior to engaging in activities of this nature, whether in the context of outside employment or otherwise. Failure to do so, or a violation of the conflict of interest policy, may result in disciplinary action, up to and including termination of employment.

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