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(Pre-employment Questionnaire) (An Equal Opportunity Employer)

    APPLICANT INFORMATION

    Name*: (Last, First)

    Street Address and Apt #*:
    City State & Zip Code*:

    Phone Number*:
    Email:

    Position applying to *

    How did you hear about us?*

    If employee referral, what is their name?

    Have you ever worked for this company? NoYes
    If yes, When?

    Are you 18 Years or Older? YesNo

    If hired, can you submit verification of your legal right to work in the United States? YesNo

    Have you ever plead guilty or been convicted of a felony or misdemeanor?YesNo

    If you answer yes, provide a detailed explanation.

    RESUME

    Optional, if you already have education, job history, and references in your resume, please upload.

    EDUCATION

    You may skip this section if the requested information below is found on your resume.

    High School:
    Did you graduate?NoYes

    College:
    Did you graduate?NoYes

    Type of Degree and Major:

    PREVIOUS EMPLOYMENT (begin with most recent position)

    You may skip this section if the requested information below is found on your resume.

    Company Name:
    Company Phone:
    Address:
    Job Title:
    Responsibilities:
    Hire Date:
    Ending Date:
    Supervisor Name:
    May Supervisor be contacted for reference?YesNo

    Company Name:
    Company Phone:
    Address:
    Job Title:
    Responsibilities:
    Hire Date:
    Ending Date:
    Supervisor Name:
    May Supervisor be contacted for reference?YesNo

    Company Name:
    Company Phone:
    Address:
    Job Title:
    Responsibilities:
    Hire Date:
    Ending Date:
    Supervisor Name:
    May Supervisor be contacted for reference?YesNo

    GENERAL

    What other skills or experiences have you had which may be relevant to this position? (example military, software, or technical experience).

    If you are hired by the company, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You will be required to submit to a pre-employment drug testing, background check, and COVID-19 Nasal Swab. You cannot be hired if you cannot comply with these requirements

    AUTHORIZATION

    If hired, I agree to abide by all Company work rules, policies, and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time.

    Signature*