Application for Employment

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 of all statements contained herein and the references and employers listed above 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 from any damage that may result from the 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 specific period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

I also authorize my photograph to be taken for the purpose of establishing an employee file, and will have no effect on my status as an applicant for employment.









In Case of Emergency:


Employment:




Availability: Please specify Afternoon, Evening, Botg or NO in each box below
*Afternoon shifts availability: 10am-6pm
*Evening shifts availability: 4pm-2am
Shift times vary by department.







Employment History:
Please include in box, Month & Year, Company, Phone, Position, Supervisor



Education:
Please fill out in each box below, where you went, years attended, and if you graduated



Skills, Licenses, and Certificates (list any that you feel valuable to this application):