Employment Application Employment Application Step 1 of 4 25% Employment ApplicationYour Name First Middle Last Apartment/Unit # City State / Province / Region ZIP / Postal Code Your PhoneDesired Salary Desired Position Select Desired: Full Time / Part Time means of transportation How did you hear about us? Are you authorized to work in the U.S.? Yes No Date Avaibale If hired MM slash DD slash YYYY Have you ever worked for this company? Yes No If so, when? Have you ever been convicted of a felony? Yes No If yes, what for & when?" Are you able to bend, stoop and twist repeatedly to complete tasks? Yes No Are you able to lift 30 pounds above your head? Yes No Are you able to lift, pull and push up to 80 pounds repeatedly? Yes No Are you able to stand for up to 6 hours at a time? Yes No Are you able to wear the following safety equipment: hard hat, safety glasses, hearing protection, work gloves and steel toe or composite toe footwear? Yes No EDUCATIONHigh School Location From To Did you graduate? Yes No GED? Street Address College Location From To Did you graduate? Yes NO Degree Other Location From To Did you graduate? Yes No Degree MILITARY SERVICEAll applicants are considered for employment without regard to race, color, national origin, religion, sex, age, marital or veteran status, or disability.BranchFromTo Add RemoveAll applicants are considered for employment without regard to race, color, national origin, religion, sex, age, marital or veteran status, or disability. REFERENCESPlease list three professional (non-relative) references.Full Name Relationship Company PhoneFull Name Relationship Company PhoneFull Name Relationship Company PhoneAddress PREVIOUS EMPLOYMENT (LIST MOST RECENT FIRST)Company PhoneAddress Supervisor Job Title Starting Pay $ Ending Pay $ Responsibilities From To Reason for Leaving Company PhoneAddress Supervisor Job Title Starting Pay $ Ending Pay $ Responsibilities From To Reason for Leaving Responsibilities From To Reason for Leaving Company PhoneAddress Supervisor Job Title Starting Pay $ Ending Pay $ Responsibilities From To Reason for Leaving DISCLAIMER AND SIGNATUREI certify that all of the information in this employment application is true and complete to the best of my knowledge, and I authorize investigation of all statements contained Your Full Name Date MM slash DD slash YYYY