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APPLICATION FOR EMPLOYMENT

First Name *

Last name *

Phone Number *

Emergency Contacts *

What is your email? *

Are you 18? *

Date of birth *

Do you have reliable transportation to and from work? *

Are you a US Citizen or authorized to work in the United States? *

How did you hear about us? *

What job position are you applying for? *

Will you consent to a mandatory controlled substance test? *

Have you ever been convicted of a criminal offense? *

If yes, please state the date of conviction, nature of the crime(s), where convicted, and disposition of the case: *

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Previous Employment (3 years minimum, start with most recent) Include month and year. *

What city/state are you currently in? *

What days of the week are you available for work? *

What hours or shifts are you available for work? *

When can you start? *

If needed, are you available to work overtime? *

Job Skills/Qualifications *

Education / Training *

3 References & Contact info *

Resume upload *

Captcha

AT-WILL EMPLOYMENT. The relationship between you and ACME Employment Inc. is referred to as "employment at will." This means that

your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or ACME Employment

Inc. No representative of ACME Employment Inc. has authority to enter into any agreement contrary to the foregoing "employment at will"

relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or

representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and

either our Vice-President or the Company's President.

AUTHORIZATION. I attest that all information submitted on this application is true and complete to the best of my knowledge and understand

that falsified statements on this application may be grounds for termination..employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she

should contact a company representative.