Employment Application Step 1 of 7 14% Name* First Middle Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Secondary Phone Postion Applying For?*Are you between 19 and 70 years of age?*YesNoIf hired, do you have a reliable means of transportation to work?*YesNoHow did you find out about this job?*If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?*YesNoDo you have any objection to a drug screen prior to employment?*NoYesPerson(s) to call in case of emergency*NameDaytime PhoneEvening Phone High School Education*SchoolAddressDates Attended College/Trade School EducationCollegeAddressDegree Other EducationMilitary Service Current Employer*Company Name and Phone #Job TitleRate of PaySupervisorDates Employed Current Employment Description* Please give a brief description of your previous duties, reasons for leaving previous work and the dates at which you were previously employed.Previous Employers*Company Name and Phone #Job TitleRate of PaySupervisorDates Employed Previous Employment Description* Please give a brief description of your previous duties, reasons for leaving previous work and the dates at which you were previously employed. References*NameRelationshipPhone NumberAddress Please list 3 refences Locations you're interested in working at* 156th & Harrison St. 147th & W. Maple Rd. 123rd & Giles Rd. 168th & W. Dodge Rd. 144th & Hillsdale Ave. 168th & W. Maple Rd. 180th & W. Center Rd. 8930 S. 137th Cir. 90th & Ohio St. 72nd&Cornhusker Date you can start Availability* Please tell us what days you are available to work. We are open 5 a.m. to 11 p.m. Sunday - SaturdayHave you ever worked for this company before?*NoYesHave you ever been convicted of any criminal activity, misdemeanor or felony?*NoYesIf yes, state where, when, and nature of offense* Note: Information regarding conviction record will not necessarily bar applicant from employment, but will be reviewed in light of duties relating to the job sought. Comments Here is your chance to tell us anything else you think we might need to know.Captcha I certify, on penalty of dismissal, that all statements and information on this employment application are true. I further certify that I understand that there may include an investigative report whereby information may be obtained through interview with me and/or family members, former employers, financial sources, friends, neighbors or other acquaintances. This inquiry may include information as to my character, general reputation, and mode of living. Although the company normally expects to furnish continuous employment to its employees; the employment of any employee can be terminated with or without cause or any time at the option of either the company or the employee. No employee, representative, manager, official, or supervisor of the company other than the president or vice president has any authority to enter into any agreement for employment for a specified period of time or take any agreement relative to employment that is contrary to the foregoing.