| APPLICATION FOR EMPLOYMENT | |||||||||
| page 2 | |||||||||
| REFERENCES give the names of 3 persons not related to you, whom you have know for at least one year | |||||||||
| NAME | ADDRESS | BUSINESS | YRS KNOWN | ||||||
| AUTHORIZATION | |||||||||
| "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand | |||||||||
| that, if employed, falsified statements on this application shall be grounds for dismissal. | |||||||||
| I authorize investigation of all statements contained herein and the references and employers listed above to give you | |||||||||
| any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, | |||||||||
| and release the company from all liability for any damage that my result from utilization of such information. | |||||||||
| I also understand and agree that no representative of the company has any authority to enter into any agreement | |||||||||
| for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and | |||||||||
| signed by an authorized company representative. | |||||||||
| This waiver does not permit the release or use of disability-related or medical information in a manner prohibited | |||||||||
| by the Americas with Disabilities Act (ADA) and other relevant federal and state laws." | |||||||||
| DATE______________________ | SIGNATURE____________________________________________________ | ||||||||
| INTERVIEWED BY_______________________________________________ DATE____________________ | |||||||||
| ________________________DO NOT WRITE BELOW THIS LINE________________________ | |||||||||
| REMARKS | |||||||||
| NEATNESS | CHARACTER | ||||||||
| PERSONALITY | ABILITY | ||||||||
| HIRED | FOR DEPT. | POSITION | WILL REPORT | SALARY WAGES | |||||
| APPROVED: 1. ______________________________ 2. ________________________________ 3. _________________________ | |||||||||
| EMPLOYMENT MANAGER | DEPARTMENT HEAD | GENERAL MANAGER | |||||||
| Go to main page | |||||||||