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Application for Employment

Complete the application below and attach your resume. We read every application.

Applicant instructions

Thank you for your interest in working at our facility. We appreciate your application and look forward to the possibility of your joining our team.

Please complete the application. Be sure all blanks are completely filled out. Addresses must be complete with zip codes and apartment numbers. Use the abbreviation N/A if a particular provision or section in the application is not applicable to you.

You may indicate your interest in as many job openings as you like on one application. Applications and attached documents become the property of this facility once they have been submitted. You are responsible for ensuring that copies of any documents that you wish to attach to your application are, in fact, attached. All required resumes, transcripts, tests and certifications must be attached to the application when submitted. If you already have these documents on file with our office, please let us know when you submit your application.

We will submit your application to the hiring supervisor and you will be contacted by them if you are selected for an interview.

An incomplete application will not be considered. Applications will be held open for ninety days. After ninety days, if you are still interested in a position with our company, you will need to resubmit an application.

Employment decisions are made solely on the basis of qualifications to perform the work for which you are applying. Qualifications include education, training, work experience and other factors which are relevant in determining job performance. Credentials and experience will be verified through schools, former employers and licensing/certification agencies, if applicable. As an Equal Opportunity Employer, decisions to hire and promote are made without regard to race, color, creed, national origin, sex, physical or mental disability (unrelated to ability to do the job) or age (as defined by law).

Please note the following before you apply

E-Verify and Form I-9

The Company utilizes the E-Verify system for all employment verifications. In accordance with the Department of Justice, Immigration & Naturalization Service, you will be required to complete an Employment Eligibility Verification form I-9 and furnish documents in accordance with the list of acceptable documents. This requirement must be met at the time of employment.

Annual TB testing

Federal and state regulations require that all employees be tested annually for TB. If you have had a TB test within the last year you must contact your previous employer and provide this facility with a copy of your test showing the dates of test and results. If you test positive we require, prior to employment, documentation from the health department that verifies that you (1) will always test positive, (2) the reason for the positive results, and (3) that you are eligible to work in this industry.

Work injury program

This facility does not subscribe to the workers compensation program. We handle employee injuries that occur on the job through our own work injury program. You will have certain responsibilities in that regard if you are employed and wish to have such benefits available to you.

Drug policy

Per our drug policies and procedures, this facility may perform pre-employment and for-cause testing for alcohol or awareness-altering substances.

Position you are applying for

Your details

First name

Last name

Phone

Address

City

State

Zip

Availability

Preferred shift

Type of employment

Salary

Date available

Are you available to work weekends?

Yes No

Are you available to work evenings?

Yes No

Disclosures

Have you been discharged or asked to resign in the last five years?

Yes No

If yes, why?

Have you ever been convicted of a crime or felony under any name?

Yes No

A conviction does not automatically bar you from employment. Each case is considered individually in relation to the position applied for.

If yes, why?

Education

High school

High school diploma?

Yes No

Received GED?

Yes No

College

College degree?

Yes No

Other college or skills

Licenses & certifications

Are you currently:

Are you eligible for:

Start date

End date

If licensed, registered or certified, please enter the dates above.

Employment history

Your most recent employer.

Company

Phone number

Address

Job title

Immediate supervisor

Salary

Reason for leaving

Nature of duties

May we contact them?

Yes No

Other jobs you would like to list

Additional information

Do you have any commitments or agreements with another employer that might affect your employment with this facility?

Yes No

If yes, please explain

Any change of name, use of assumed name or nickname necessary to enable a check on your record (if applicable)

Resume

Upload your resume

Optional. PDF, DOC, DOCX, RTF or TXT, up to 10 MB.

Acceptance of application terms

I authorize you, at the time of my application for employment or in the course of my employment, to obtain information from any source as to my education, experience, competence, character or medical history, as it relates to the position for which I applied or in which I may be employed unless otherwise stated. I certify that the information contained in this application is true, complete, and correct to the best of my knowledge and belief, and understand that if I am hired, this application will be transferred to my individual personnel file. I understand that any falsification or omission of information may cause my immediate dismissal or rejection of this application. I agree that all statements made in this application may be investigated. I also understand that I may be required to successfully complete a medical exam, to include a urine drug screen, for initial and/or continued employment. I further understand that any employment is not for a stated period of time and may be terminated with or without cause, at any time, at the option of either myself or my employer. If I am employed, I agree to comply with and be bound by the rules and procedures of this facility.

I am legally eligible for employment in the United States.

I have read and accept the application terms and the drug policy above, and I certify that the information in this application is true, complete and correct.

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