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This company is an equal employment opportunity employer. All applicants will be considered without regard to age, race, national origin, religion, disability, sex or other protected status in accordance with applicable federal and state equal employment opportunity laws. This company will strive to accommodate any physical or mental limitations of employees or applicants in order to accomplish the essential functions of the job.

Education
Special Skills, Qualifications and Considerations:

Summarize special skills and qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking:

REFERENCES:

List three(3) non-relatives who are familiar with your qualifications, work history, and ability.

Name Occupation/Relationship Year Known Telephone
Employment Experience:
1. PREVIOUS EMPLOYMENT
2. PREVIOUS EMPLOYMENT

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK THEM BEFORE SIGNING.

I certify that all answers and statements I have made on this application (and resume or other supplementary materials) are true and complete without omissions. By signing below, I authorize THE COMPANY to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if I am employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, character and qualifications.

If hired I will be responsible for familiarizing myself with all rules and regulations of THE COMPANY as they presently exist or are later modified. If hired, I understand my employment can be terminated, at the discretion of THE COMPANY or at my option, without notice, at any time and for any reason.

I also understand that no representative of THE COMPANY has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the president of THE COMPANY.

I understand this application is not an offer of employment and no promises or representations of employment have been made to me at this time.

09/29/2023