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Part-Time Employment Application

  1. Are you eligible to work in the United States?

  2. Have you ever worked for this organization?

  3. Have you ever been convicted of a felony?

  4. Education

  5. Did you graduate?

  6. Did you graduate?

  7. Did you graduate?

  8. Previous Employment

  9. May we contact your previous supervisor for reference?

  10. May we contact your previous supervisor for a reference?

  11. May we contact your previous supervisor for a reference

  12. Military Service

  13. Are you currently in the Armed Forces?

  14. References

    Please list three professional references.

  15. Disclaimer

    I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment. I understand that the company may require me to successfully complete a pre-employment drug and alcohol test as a condition of employment and that continued employment may be based on the successful completion of similar tests. I understand that the company may as part of the hiring process request an investigative consumer report from a third party entity or agency including information concerning my character, general reputation, personal characteristics, credit records, and mode of living. I may make a written request to the company to provide me with additional information regarding the nature and scope of any such report. I understand that employment with your company is “at will” and nothing in the interview or hiring process, this application, or your company policies are intended to create an employment contract between myself and the company. Employment may be terminated by either party at any time for any reason with or without notice.

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  17. This field is not part of the form submission.