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To the applicant: We appreciate your interest in our company and assure you that we are interested in your qualifications. A clear understanding of you background and work history will assist us in seeking to place you in a position, which, in our judgment, best meets your qualifications.

We are an equal opportunity employer and will not unlawfully discriminate on the basis of race, color, sex, sexual orientation, gender identity, religion, national origin, age, marital, veteran status, height, weight, disability, or any other characteristic protected by federal, state, or local law.

Federal law requires employers to make accommodations to disabled applicants and employees where the accommodation does not impose an undue hardship on the employer.

Disabled employees and applicants may request an accommodation of their disability by notifying the company in writing of the need for accommodation within 182 days of the date the person with a disability knows or should know that an accommodation is needed. Failure to properly notify the company will preclude any claim that the employer failed to accommodate the person with a disability.


Are you 18 years or older *
Can you,after employment, submit verification of you legal right to work in the United States? *
Have you been previously employed here? *
Have you filed an application here before? *

Employment Desired

Kind of work sought: *
Do you have any activities, commitments, or responsibilites (for example, school, other employment, etc) which might, in any way, interfere with your ability to work full time, including overtime, in the position for which you are applying? *


List your last four employers, starting with the most recent one first.


Elementary School

High School





Do not include relatices or former employers

Military Service Record

Additional Information

Are you currently bound by any agreement with a former employer that would prevent you from working here?*
Have you ever been convicted of a crime?*
Have you have any felony charges pending against you?*
Do you have a valid driver's license?*

Authorization and Understanding

Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application is true and complete. I authorize the company to verify any of the information concerning my employment, education, credit, or medical history with the appropriate individuals, companies, institutions, or agencies, and I authorize them to release such information as you require, including my prior disciplinary employment record, without any obligation to give me written notice of such disclosure. I authorize the company to obtain my credit report and criminal history for use in considering my application for employment, and, if hired, for promotions or continued employment. I also authorize the company to release any information requested by any of my prospective or subsequent employers without any obligation to give me written notice of such disclosure hereby release the company and them from any liability whatsoever as a result of any such inquiries and disclosures. I agree that any false information in support on my application my subject me to discharge at any time during the period of my employment.

If I am hired by the company, I will be prohibited from disclosing any company trade secrets or other confidential/proprietary information except as necessary in the course of performing my job.

Should I receive a conditional offer of employment, I agree to submit to a medical examination to evaluate my fitness for duty. I understand this may include a drug screen.

I agree that either party may terminate the employment relationship, with or without cause, at any time, and I further agree that this arrangement may only be altered in writing directed to me personally and signed by the president of the company. I agree that I shall be bound by other rules, policies, regulations, and terms and conditions of employment of the company as they are from time to time changed.

I agree that any action or suit against the company arising out of my employment or termination of employment, including, but not limited to, claims arising under state or federal civil rights statuses, must be brought within one year of the event giving rise to the claim(s) (or the statutory limitations period, if shorter), or be forever barred. I waive any limitation periods to the contrary.