Type of Work Desired * Are you 18 years of age or older? * (If under 18, please state your age) * Are you on lay-off subject to recall elsewhere? * (If yes, explain) * Date Available for Employment * Minimum Salary Requirement: * * Have you made previous application to this organization? * (If yes, when?) * Have you been employed here previously? * (If yes, when and what position?) * Have you ever been convicted of, or pled guilty or "no contest" to, a misdemeanor or felony? (do not include minor traffic infractions for which you never appeared in court, offenses which were dismissed or discharged after completion of successful probation, and convictions or pleas which have been deemed sealed or expunged by law)? * If Yes, give details concerning the type of crime, the date of the conviction or plea, the penalty imposed, and any other circumstances you deem relevant to a full understanding of what occurred. * Have you been arrested and charged with any misdemeanor or felony not disclosed above for which you are out on bail or free on your own recognizance pending disposition or trial (again, do not include minor traffic infractions for which no court appearance is necessary)? * If Yes, give the date(s) and details of the arrest or charge and any other circumstances you deem relevant to a full understanding of what occurred. * Have you ever been sued in a civil action with regard to the death of, or personal injury or intentional damage to any person? * If Yes, give details concerning the nature of the claims and defenses raised by the parties, the outcome of the action (e.g., settlement, jury verdict, or other disposition), and any other circumstances you deem relevant to a full understanding of what occurred. * NOTE: Answering "Yes" to the two previous questions is not an automatic bar to employment. Factors such as age at the time of the offense, seriousness and nature of the violation, relatedness to the job sought, and evidence of rehabilitation will be taken into account. However, please be advised that a misstatement or omission in answering these questions may be grounds for disciplinary action, including discharge. Number of days absent from work last year: * Do you have transportation to work? * Will you work overtime if asked? * Summarize special job related skills and qualifications acquired from employment or other experience PLEASE READ THE FOLLOWING STATEMENTS BEFORE SIGNING BELOW
The facts set forth in my application are true and complete. I authorize the investigation of all statements contained in this application and hereby authorize my former employers to furnish all information pertaining to my work record. I hereby release my former employers from all liability on account of furnishing such information. I understand that false statement, omissions or misleading statements on this application shall be considered sufficient cause for refusal to hire or dismissal and I agree that my employer shall not be held liable in any respect if my employment is terminated because of such omissions or false or misleading states.