Employment Application

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First

Last

Address

Street Address

Address Line 2

City

State / Province

Zip / Postal Code

Phone number

Cell phone number

Email address

Are you at least 18 years old?

What date are you available to start?

Have you been given a job description or had the requirements of the job explained to you?

Do you understand these job requirements?

Can you perform the requirements of this job without accommodation including regular lifting of 25 pounds and use of a 12 pound back pac vacuum?

Please Note:

Your application will not be considered unless correct telephone numbers of past employers are included and all information is filled out. If you need help please call and ask.

For which position are you applying?

List three things that are important to you in your work enviroment:

Three characteristics that best describe you:

Why do you want to work here?

Please list any classes or workshops you have taken that pertain to the field:

Please list any special interests, hobbies and skills:

Additional information you would like us to know about your values, desires and work ethic:

Are you taking any medication or have any medical conditions that could impact your safety or the safety of others while on the job?

Yes

If yes, please explain:

Please check the box below acknowledging that you understand our drug policy.

I understand that this is a DRUG FREE & TOBACCO-FREE FACILITY AND WORK PLACE.

If you are human, leave this field blank.