APPLICATION FOR EMPLOYMENT
Federal and State law requires that all applicants be considered without regard to race, religion, color, sex, age
or national origin. We believe in and fully support the principle of equal employment opportunity and fulfill
our obligation to the fullest
How did you hear of opening?
Have you worked with us before?
If Yes, please explain listing previous Job/Title/Location and Length of service:
What was your reason for leaving?
List any friends and/or relatives working with us now:
Do you speak any foreign language fluently?
Are you under age 18: Yes No
If yes, please provide your age:
If you are under age 18, can you supply working papers?
Only U.S. Citizens or legal aliens with work authorization are eligible for employment.
Can you, upon employment, provide genuine documentation establishing your identity
and eligibility to be legally employed in the United States?
Have you ever trained in the Unites States military?
If Yes, please give date:
Are you able to perform the essential requirements of the job? Yes No
If No, are there reasonable accommodations that can be made to allow you to perform the essential
functions of the job?
List professional, trade, business, or civil activities and offices held.
(You may exclude memberships which may reveal sex, race, religion, national origin, age or disability
or other protected status)
FTE (up to 78 hours biweekly)
PT (up to 56 hours biweekly)