Thank you for your interest in employment with our Company. We appreciate your application
and look forward to the possibility of you joining our team. This sheet is for your information;
please read it carefully.
If you need any assistance or accommodation to complete this form please contact us at firstname.lastname@example.org
Incomplete applications will not be considered. Use the abbreviation "N/A" if a
particular provision or section in the form is not applicable to you.
This application form is intended for use in evaluating your qualifications for employment. This
is not a contract for employment. False or misleading information given in this form or during
the interviewing process are grounds for terminating the application process or, if discovered
after employment, for terminating employment. A background check and/or consumer report
may be requested by the Company.
Employment decisions are made solely on the basis of qualifications to perform the work for
which you are applying. Qualifications include education, training, and work experience.
Credentials and experience will be verified through schools, former employers, and any other
applicable sources. As an Equal Opportunity Employer, we make decisions to hire and promote
without regard to race, color, age, religion, sex, national origin or ancestry, disability or physical
condition, parental status, sexual orientation, gender identity, marital status, level of income, or
other legally protected status.
You should understand that the position for which you are applying is considered at-will, which
means that either you or the company can terminate employment for any reason or no reason
at any time. No one except the company president has the authority to amend this agreement.
We appreciate your interest.
I have read and understood the above information
Complete the following information only if applying for a position that requires use of a
vehicle while conducting company business. If hired, your information will be verified with a
Motor Vehicle Report.
I certify that answers given herein are true and complete to the best of my knowledge. I
authorize investigation of all statements contained in this application for employment as may be
necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed
180 days. Any applicant wishing to be considered for employment beyond this time period
should inquire as to whether or not applications are being accepted at that time.
I understand that I may be required to successfully complete a pre-employment physical
examination conducted by a company-authorized physician and that I may be required to
successfully pass a pre-employment drug/alcohol screening after I accept a conditional offer of