At-Will Application for Employment CD Snow Hill, Snow Hill, NC

THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex. race, color, religion, age, marital status, national origin, citizenship, disability, veteran status, or any other status protected under state and federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a medical examination, which may include providing body substance samples. This application will remain active for 90 days.

Personal Information

First Name *

Last Name *

Present Address *

City *

State *

Zip Code *

Since (Month/Year) *

Previous Address (if less then 5 years at current address)

City

State

Zip Code

Since (Month/Year)

Previous Address

City

State

Zip Code

Since (Month/Year)

Email Address *

Phone

Cell Phone

If referred to this job please fill in the name of the person who referred you

Education

High School *

City, County & State *

0/50 characters

Did You Graduate? *

Yes

GED

Undergraduate College

City, State

0/50 characters

Area of Study

Degree/Certification/Diploma

Other Schools

Employment Information

Position Applying For: *

Do You Prefer: *

Full-Time

Part-Time

Do You Prefer: *

1st Shift 7-3:30

2nd Shift 3:30-12

No preference

Can You Work: *

Weekends

Evenings

Overtime

Any

Are you at least 18 years old and legally authorized to work in the United States? *

Yes

Wil you work overtime when necessary? *

Yes

Are you on layoff and subject to recall? *

Yes

Are you currently bound by a noncompetition or trade secret agreement? *

Yes

If yes, please explain.

Have you ever been discharged or asked to resign from a job? *

Yes

If yes, please explain.

Have you ever been convicted of or pled guilty to a felony or other crime? *

Yes

If yes, please explain.

Employment History

Employer 1

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact? *

Yes

Phone Number

Employer 2

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact?

Yes

Phone Number

Employer 3

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact?

Yes

Phone Number

Job Related Skills

List any additional skills that you may have related to the position applied for:

List any professional licenses, designations, certifications, etc. that may relate to the position applied for. Include date granted, the name of the organization, and any other relevant information.

Please submit a copy of your resume.

Applicant's Certification Agreement

1. I authorize the investigation of all statements contained in this application and release from all liability any persons or employers supplying such information. I also release the company from all liability which might result from making the investigation.

2. I certify that the facts and information set forth in this application are true and compete to the best of my knowledge. I understand that any falsification, misrepresentation or omission of facts on this application (or on any required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.

3. I agree if I am offered and accept a position, to conform to all existing and future Company rules and regulations, and I understand that the Company reserves the right to change wages, hours and working conditions as deemed necessary. I ALSO UNDERSTAND THAT IF HIRED, MY EMPLOYMENT WILL BE AT-WLL, MEANING THAT EITHER PARTY CAN END THE EMPLOYMENT RELATIONSHIP AT ANY TIME AND FOR ANY OR NO REASON.

4. I understand that any employment offer is contingent upon my providing within three (3) working days of employment, valid proof of identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986.

5. I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely and fully.

clear

Date +