Standard Application for Employment
It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex,
religion, national origin, disability or other protected classifications.
Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions
on this application. You may attach a résumé, but all questions
must be answered.
Position applying for
Name (last, first, middle)
Street Address and/or Mailing Address
Home Telephone Number
Business Telephone Number
Cellular Telephone Number
Do you have a High School Diploma or GED?
POSITION INFORMATION Check all that you are willing to work
Hours: Full Time
Are you authorized to work in the U.S. on an unrestricted basis? Yes No
Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.) Yes No
If yes, explain:
Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job?
Can you perform these essential functions of the job with or without reasonable accommodation? Yes
QUALIFICATIONS Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges,
degrees, vocational or technical programs, and military training.
SPECIAL SKILLS List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.
REFERENCES Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three
professional references, then list personal, unrelated references.