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Employment Application

  • Section One
  • Section Two
  • Section Three
  • Section Four

Personal Information

Name (Last, First)

Social Security Number

Present Address

City

State

Zip

Phone Number

Are you 18 years of age or older?

Desired Employment

Position

Date you can start

Salary desired

Are you employed now?

If so, may we contact your present employer?

Ever applied to this company before?

If yes, where?

When?

Ever worked for this company before?

If yes, where?

When?

Reason for leaving?

Name of last supervisor at this company

Who referred you to this company?

Education

School Level

Name and location of school

No. of years attended

Did you graduate?

School Level

Name and location of school

No. of years attended

Did you graduate?

List any subjects of special study or research work

List any special training you have

List any special skills you have

References

Below, give the names of three persons you are not related to whom you have known at least one year.

Name

Business

Phone Number

Years Acquainted

Name

Business

Phone Number

Years Acquainted

Name

Business

Phone Number

Years Acquainted

Service Record

Branch of Service

Discharge Date and Rank

Criminal Record

Have you been convicted of a felony within the last 5 years?

If yes, explain. (Will not necessarily exclude you from consideration.)

Authorization

“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION O FALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.”

Date

Your Name (This will serve as your electronic signature.)

Employment History

List below your last three employers starting with the most recent one first.

Name of Present or Last Employer

Address

City

State

Zip

Starting Date

Leaving Date

Job Title

Weekly Starting Salary

Weekly Final salary

May we contact your supervisor?

Name of Supervisor

Job Title

Phone Number

Description of Work

Reason for Leaving

Name of Present or Last Employer

Address

City

State

Zip

Starting Date

Leaving Date

Job Title

Weekly Starting Salary

Weekly Final Salary

May we contact your supervisor?

Name of Supervisor

Job Title

Phone Number

Description of Work

Reason for Leaving

Name of Present or Last Employer

Address

City

State

Zip

Starting Date

Leaving Date

Job Title

Weekly Starting Salary

Weekly Final Salary

May we contact your supervisor?

Name of Supervisor

Job Title

Phone Number

Description of Work

Reason for Leaving

Resume and Cover Letter

Please upload your current resume and cover letter

Background Check Application

INSTRUCTIONS: PLEASE COMPLETE IN FULL. PRINT ALL INFORMATION. FALSE INFORMATION IS CAUSE FOR REJECTION OR DISMISSAL.

Name (First - Middle - Last)

Social Security Number

Address

City

State

Zip

Telephone (Home)

Telephone (Work)

Valid Driver's License

State Issued

License Number

Date of Birth as Shown

Date Expires

Race

Sex

Which location are you applying for?

Have you been - (1) Convicted of a drime, excluding traffic offense? - (2) Placed on deferred adjudication, or - (3) Are you currently on probation or parole?

Explain any

I UNDERSTAND THAT ALL INFORMATION SUBMITTED AND CONSIDERED IS SUBJECT TO VERIFICATION. I UNDERSTAND AND HEREBY AUTHORIZE AND GIVE PERMISSION FOR AACA TO CONDUCT VERIFICATION OF MY CRIMINAL HISTORY, DRIVING RECORD, EMPLOYMENT HISTORY, AND OTHER INVESTIGATIONS RELATED TO MY EMPLOYMENT WHICH ARE NECESSARY TO DETERMINE MY QUALIFICATIONS FOR A JOB. I UNDERSTAND THAT IF I AM HIRED, I MAY BE SUBJECT TO A CRIMINAL HISTORY, DRIVING RECORD CHECK. I CERTIFY THAT ALL STATEMENTS AND ANSWERS TO ALL QUESTIONS IN THIS APPLICATION ARE TRUE, COMPLETE AND CORRECT AND ARE MADE IN GOOD FAITH.

Date

Your Name (This will serve as your electronic signature.)