ABOUT OUR COMPANY

Thank you for your interest in applying for a job with our Company. Because of our commitment to offering the highest possible satisfaction to our customers, we are only interested in hiring the best. We want to have a complete understanding of your qualifications, motivations, and interests, so that we can make a careful and deliberate hiring decision that will benefit both the Company and our employees. Please answer the following questions honestly, completely and thoughtfully. We are an Equal Opportunity Employer and do not discriminate on the basis of race, color, religion, sex, national origin, age, marital status, veteran status, handicap or disability.

PERSONAL INFORMATION

Last Name *

Middle Initial

First Name *

Address - Street *

City *

State

Zip *

Telephone *

If you are under 18 years of age, do you have a work permit?

Yes

No

If you have ever worked under another name, please identify:

YOUR JOB INTERESTS

Position Desired

Date You Can Start Work

What Starting Salary or Wage Do You Expect?

Per hour

Are You Available for Full-Time Work?

Yes

No

Are You Available for Part-Time Work?

Yes

No

Are You Willing to Work Any Shift?

Yes

No

Are There Any Days Of The Week When You Would Not Be Able To Work? Please Specify

How Did You Learn of This Job?

Have You Ever Worked For This Company Before?

Yes

No

When?

Who Was Your Supervisor?

Why Did You Leave?

Do You Know Anyone Who Works Here?

Yes

No

Who?