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Employment Application

Name & Contact Information

Last Name *

First Name *

Middle Name

Regular Address 1: *

Regular Address 2:

City *

State *

Zip Code *

Do you have a temporary address? YesNo

Temporary Address 1:

Temporary Address 2:

Temporary City

Temporary State

Temporary Zip Code

Phone Number: *

Email *

Employment Related Information

What position are you applying for?

When will you be available to work?

How did you first learn of this job opening?
NewspaperEmployee ReferralWalk-InWebsite (Indeed, Facebook, Monster, Other)Job Fair

What newspaper?

What is your referral's name?

What website?

Have you ever applied for a job with us? YesNo
Have you ever worked for us? YesNo

When did you work for us? (Please enter dates.)

Availability

Check the following options you would consider:
Part-TimeFull-TimeTemporary
List any days you are not available to work: MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Are you legally eligible for employment in the United States? (Proof of citizenship or authorization to work in the United States will be required on employment.) YesNo

Have you ever been convicted of a felony, or pleaded no contest to a felony, or been convicted of a misdemeanor resulting in imprisonment. (Conviction will not necessarily disqualify an applicant, but will be considered in relation the specific job requirements.) YesNo

If yes, please explain.

Please rank in numerical order (1-4) your interest in these work assignments, with 1 being your first preference. (Warehouse, Corporate Office, Retail Store, Other – Please specify)

Desired Salary: *

Education

Have you received your HS Diploma or GED? YesNo

Name of University:

Major/Degree:

List any certificates, other education, knowledge, special technical or computer skills, and/or individual capabilities you have which especially prepare you for the position you have applied for:

Employment History/Experience

Starting with most recent position, list all employers; use additional sheet if necessary. Furnish dates and explanations for each period of unemployment of one month or more. A resume may be attached as a supplement.
Have you worked previously?
YesNo

Past or Current Employer

Employer:

Address:

Starting Date:

End Date:

Job Title:

Briefly Describe Work Responsibilities:

Supervisor:

Supervisor Phone Number:

Starting Pay:

Ending Pay:

May We Contact? YesNo

Reason For Leaving:

Additional Employment

Add Second Employer

Employer:

Address:

Starting Date:

End Date:

Job Title:

Briefly Describe Work Responsibilities:

Supervisor:

Supervisor Phone Number:

Starting Pay:

Ending Pay:

May We Contact? YesNo

Reason For Leaving:

Add Third Employer

Employer:

Address:

Starting Date:

End Date:

Job Title:

Briefly Describe Work Responsibilities:

Supervisor:

Supervisor Phone Number:

Starting Pay:

Ending Pay:

May We Contact? YesNo

Reason For Leaving:

Professional Reference (1)

Name *

Title *

Business Name *

Relationship To You *

Phone *

Email:

Professional Reference (2)

Name *

Title *

Business Name *

Relationship To You *

Phone *

Email:

Professional Reference (3)

Name *

Title *

Business Name *

Relationship To You *

Phone *

Email:

Resume

If you have a resume, please upload it here. (Acceptable file types: pdf, doc, docx)

Application Statement

I have answered all questions to the best of my ability. If employed, I realize false, misleading or incomplete information I give or withhold on this application or during my interview(s) or at any other time during the hiring process may disqualify me from employment or may lead to my discharge once I have been hired.

I agree that any employment relationship with this Company will be of an “at-will” nature, meaning I may resign at any time and the company may discharge me at any time, with or without cause and with or without prior notice. I understand that this “at-will” employment relationship may not be changed by any written document, oral statement or conduct unless the change is specifically acknowledged in writing by the Company’s President. I understand that any oral or written statements that differ from this explanation of the “at-will” nature of employment at this Company are expressly disavowed and I understand that I should no rely on such statements. If required by the position applied for, I understand I may have to undergo physical examinations, drug screenings, ability tests or other tests during the application process or after a conditional offer of employment is extended.

I understand that the Company will perfom a reference check before considering my for employment; if an offer is extended, I understand the Company may also conduct a background check and, depending on the position, may conduct drug testings. I authorize this Company to: (1) Investigate the truthfulness of all statements made on this applicaton; (2) Contact my former employers and other listed references or any other persons who can verify information; (3) Discuss the results of any investigation with other employees of the Company involved in the hiring process. I give my consent for all contacted persons, firms and corporations, including former employers, to provide information concerning this applicaton, and I release each such person, firm or corporation from liability for providing information to the Company. I also release Sturdevant’s SAE Warehouse, INC and it’s representatives from liability for seeking this information.

I agree to conform to the policies, work rules and procedures of Sturdevant’s SAE Warehouse, INC including affiliated companies, if I am hired.

I agree to the Application Statement above. *

Employment Application

Name & Contact Information

Employment Related Information

Availability

Education

Employment History/Experience

Past or Current Employer

Additional Employment

Professional Reference (1)

Professional Reference (2)

Professional Reference (3)

Resume

Application Statement

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