Equal Employment Opportunity Employer

We do not discriminate on the basis of race, color, religion, national origin, sex, age, physical or mental disability, genetic information, or any other condition protected by law or regulation. It is our intention to provide equal employment opportunities to all qualified applicants and to base selection decisions on job-related factors.

Please answer each question completely and accurately. This application will not be processed until you have answered all questions. Use blank paper if you do not have enough space on this application. Please print or complete legibly, except for your signature on the back of the application. As you read and answer the following questions, please be aware that none of the questions imply unlawful or discriminatory preferences based on information unrelated to work.

(If you are hired, you may be asked to provide proof of age)

If we employ you, you must provide proof that you are authorized to work in the United States of America (U.S.A.).

Please list the names of your employers in consecutive order; specify your current or most recent employment first. Include all periods, including military service and any periods of unemployment. If you are employed or self-employed, give the name of the company and provide business references. Note: The job offer may be contingent upon receiving acceptable references from current and previous employers.

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required. I understand that if I am extended an offer of employment, it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my signature consent to these statements.

This application for employment will remain active for a limited time. Ask the organization’s representative for details.