Employment Application

Check the following options which you wouldEMPLOYMENTAPPLICATION We are an Equal Opportunity Employer. We consider applicants for all positions without regard to race, color, creed, religion, sex, nationalorigin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, and any other legally protected status.It is our policy to abide by all Federal, State, and local laws concerning discrimination in employment. No question in this application isintended to elicit information in violation of any such law nor will any information obtained in response to any question be used in violation ofany such law. PERSONAL INFORMATION Last NameFirstMiddle Date of ApplicationStreet Address Home Phone How Long at PresentAddress?City, State, ZipWere you previously employed by this organization? Social Security No.DepartmentYes, Date (s)No Have you previously applied for work to this organization?Driver's License No. (If Applicable) DepartmentYes, Date (s)No Wages ExpectedPosition Applying For In case of emergency notify:Phone Full-TimePart-TimeCo-opSeasonalTemporary.Are you willing to workovertime?Date available for workAre you employed now? YesNo (Explain)YesNo (Explain)EDUCATION AND TRAINING NO. OF COURSE DID YOU DIPLOMA NAME AND LOCATION OF SCHOOLYEARS SCHOOLOF STUDYGRADUATEORCOMPLETEDDEGREE HIGH YesSCHOOLNo Yes COLLEGE ORUNIVERSITYNo COLLEGE OR YesUNIVERSITYNo Yes TRADENoSCHOOL Yes APPRENTICESCHOOLNo List any other education, training, special skills or certificates/licenses that you possess: List any machines or equipment that you are qualified and experienced at()() American LegalNet, Inc. www.FormsWorkFlow.com DO NOT WRITE BELOW - FOR COMPANY USE ONLY Offer to be extended?YESNObyNotified onDateInitialsConfirmed In WritingOther Weekly $Hourly $ CO-OPFull-Time TemporaryFull-Time RegularPart-Time RegularPart-Time TemporarySeasonalHours Per Week BenefitsScheduled Work DaysNoneFullProrated In addition, the Candidate will be advised of the following conditions and terms as part of this offer of employment: DATEStarting DateJob TitleWagesAPPROVEDAPPROVEDDATEAPPROVEDDATE American LegalNet, Inc. www.FormsWorkFlow.com