Employment Application

Have you filed an application with us within the past 12 months? If yes, give date

Yes

No

Have you ever been employed with us before? If yes, give date

Yes

No

Have you been convicted of a felony within the last 7 years?
(Conviction will not necessarily disqualify an applicant from employment.)

Yes

No

May we contact your present employer?

Yes

No

Are you legally eligible for employment in the U.S.?
(Proof of citizenship or immigration status will be required upon employment.)

Yes

No

On what date would you be available for work?

Are you available to work?

Full Time

Flexible Shifts (days, evenings, nights)

Part Time

Holidays

Temporary

Weekends

Can you travel if job requires?

Yes

No

Best time to contact you:
If you are under 18 years of age, can you provide required proof of your eligibility to work?			Yes	No
Have you filed an application with us within the past 12 months? If yes, give date			Yes	No
Have you ever been employed with us before? If yes, give date			Yes	No
Have you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant from employment.)			Yes	No
Are you currently employed?			Yes	No
May we contact your present employer?			Yes	No
Are you legally eligible for employment in the U.S.? (Proof of citizenship or immigration status will be required upon employment.)			Yes	No
On what date would you be available for work?
Are you available to work?	Full Time	Flexible Shifts (days, evenings, nights)
	Part Time	Holidays
	Temporary	Weekends
Can you travel if job requires?			Yes	No