Personal Information * First Name Middle Initial: * Last Name Home Address: City: State: Zip Code: * Telephone Number: * Email Address: Education * Do you possess a High School Diploma or G.E.D Certificate? Yes No Currently Enrolled School Name: Desired Employment Position: Date You Can Start: Minimum Salary Expected: * Are you employed now? YesNo If so, may we inquire of your present employer? YesNo * Have you ever applied for this company before? YesNo When? * Have you ever worked for this company before? YesNo When? Reason for leaving the company: How did you hear about our company? * Have you ever been convicted of a Felony? YesNo If yes, explain: * Have you ever been convicted of a Class A or B Misdemeanor? YesNo If yes, explain: * Have you ever been given a Deferred Adjudication sentence that has not been successfully completed? YesNo If yes, explain: Please Note: A "yes" answer to any of the three questions above will not necessarily exclude you from consideration. Under the Federal Statutes, an employer has the right to make reasonable pre-employment inquiries into your ability to perform job-related functions. Many of the job assignments for our employees require strenuous physical labor for sustained periods of time. The information you give below is for the limited purpose for our managers to determine your ability to perform these related functions and to determine reasonable job assignments for you. It will in no way exclude you from any job which you are able to perform. * Based upon the position you desire, is there any reason that you are not able to perform the duties required, with or without accommodation? YesNo If yes, explain: Former Employers Name of present or past employer: Telephone Number: Address: City: State: Zip Code: Starting Date: Ending Date: Job Title: Name of Supervisor: May We Contact Your Supervisor? YesNo Starting Salary: Ending Salary: Description of Work: Reason for Leaving: I hereby authorize investigation of all information concerning my previous employment, and any pertinent information such employers may have, personal and otherwise, and release all parties from all liability for any damages that may result from furnishing same to the Company. I declare that all statements contained in this application are true and correct, and understand that false or inaccurate information will be basis for dismissal. I hereby declare that I have legal status to work in the United States. All disputes between me and the Company are subject to final and binding arbitration under the Federal Arbitration Act and the AAA Employment Arbitration Rules and the Company Arbitration Plan. Applicant Signature Date: * Denotes Required Field Saving Information...Please Wait