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Applicationforemployment

________________________________ Name Last First Middle Present address _____ - _____ - _________ are you currently authorized to work in the United States? _____ -___N0, if "YES", can you provide proof of your eligibility to work? __________________________ How many hours can you work weekly?

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api-195424811
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32 views

Applicationforemployment

________________________________ Name Last First Middle Present address _____ - _____ - _________ are you currently authorized to work in the United States? _____ -___N0, if "YES", can you provide proof of your eligibility to work? __________________________ How many hours can you work weekly?

Uploaded by

api-195424811
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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Employment Application Form

PLEASE COMPLETE PAGES 1-3. DATE ________________________________

Name ______________________________________________________________________________________________
Last First Middle

Present address ______________________________________________________________________________________


Number Street City State Zip

How long at current address _________________________ Telephone ( )

Social Security No. _______ _____ _________

Are you under age 18 ____YES ____NO, if YES, can you provide proof of your eligibility to work? ____YES ____N0 Are you currently authorized to work in the United States? ____YES _____NO. Proof of eligibility will be required if hired. Position applied for (1) ________________________ and wage desired (2) ________________________ (Be specific) How many hours can you work weekly? _________________________ Employment desired FULL-TIME ONLY PART-TIME ONLY TEMPORARY/CONTRACT Days/hours available to work No Pref _______ Thur ________ Mon __________ Fri __________ Tue __________ Sat _________ Wed _________ Sun ________

When are you available to start work?____________________________ ____________________________________________________________________________________________________

TYPE OF SCHOOL High School College Bus. or Trade School Professional School

NAME OF SCHOOL

LOCATION

NUMBER OF YEARS COMPLETED

MAJOR & DEGREE

Have you ever been convicted of a crime? employment.)

No

Yes

(A Conviction record will not necessarily disqualify you from

Employee Referral? Name____________________________________________ UNDER MARYLAND LAW AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, OR PROSPECTIVE EMPLOYMENT OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT.

Application For Employment

APPLICATION FOR EMPLOYMENT MILITARY HAVE YOU EVER BEEN IN THE ARMED FORCES? ARE YOU NOW A MEMBER in the ARMED FORCES? Yes Yes No No

Specialty ___________________________________ Date Entered ________________ Discharge Date ______________

IMPORTANT-PLEASE SEND RESUME TO [email protected] AND SET THE SUBJET TO YOUR NAME AND BIRTHDATE EXAMPLE: JOHN DOE MM/DD/YYYY
Did you complete this application yourself Yes No If not, who did? _______________________________

After reviewing the job description from Lumii.LLCs website, please indicate if you are able to perform the essential functions of the job for which you have applied, with or without a reasonable accommodation _____ Yes _____ No.

Application For Employment

PLEASE READ CAREFULLY I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

We are an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, height, weight, or disability. We assure you that your opportunity for employment with us depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.

___________________________________ Applicant Signature

_________________________________ ________________ Print Date

Application For Employment

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