Employment Application

    Personal Information

    Additional Information

    Education History

    High School



    Employment History

    Most Recent Company

    Company 2

    Company 3


    I certify that the information contained on this application is true and correct and I understand that misrepresentation or omission of facts called for in this form is due and just cause for termination of my employment.  I also agree if and when employed,

    1. that at any time the Company may require physical examination and/or x-ray by a physician designated by the Company and that the Company may require satisfactory passing thereof as a condition of continued employment;

    2. that continued employment may be based on the successful passing of such tests, including drug tests as the Company may require;

    3. that if I leave the employ of the Company for any reason within ninety days from employment date, that the Company may deduct from my last check the cost of the physical examination and/or x-ray or other tests;

    4. to abide by all the policies, rules and regulations of the Company;

    5. to accept the uniform allowance, if any, which the Company is paying for the purchase, and/or maintenance of any uniform required to be worn during my employment, and thereby to waive any claim that I may have against the Company for reimbursement of any expense which I may incur in connection with the wearing of the uniform(s);

    6. I give permission for the employer to contact and obtain information from all references, employers, educational institutions and to verify the information contained in this application;

    7. I give permission for the employer to conduct a criminal history check to confirm the information that I have given concerning my criminal history. I hereby release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information;

    8. I understand that if I am hired, I will be required to provide proof of identity and legal work authorization.

    I understand that, if employed, this is an employment for no fixed term, terminable by my employer at any time for any reason, which understanding may only be amended in writing executed by an authorized representative of my employer.