Employment

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Application for Employment
TO APPLICANT: We deeply appreciate your interest in our organization. Thank you for taking the time to complete this application.

The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, religion, sex or national origin. Federal law also prohibits other types of discrimination such as age, citizenship, disability, veteran status, attainment of benefits, and participation in union activities. The laws of most states and many localities also prohibit some or all of the above types of discrimination as well as some additional types including, but not limited to,discrimination based upon ancestry, marital status, parental status, sexual orientation, or source of income. The Fair Credit Reporting Act imposes restrictions with respect to credit data. This list, however, is not exhaustive of the grounds on which discrimination is prohibited.

*=Required Field

PERSONAL
First Name*:
Last Name*:
Address*:
City*:
State*:
Zip*:
Phone*:
Email*:
Location*: (Toms River or Edgewater Park)
Are you eligible for employment in the USA*? (If hired you are required to submit proof of your elgibilty to work in the USA.)	YES NO
Are you over 18*? (If no, hire is subject to verification that you are of minimum legal age.)	YES NO
Position Applied For: (If known.)
If you application is considered favorable, on what date will you be available for work*?

Are there any other job related experiences, skills, or qualifications which will be of special benefit in the job for which you are applying?

EMPLOYMENT HISTORY

List below present and past employment, beginning with your most recent.

1   Name & Address of Company & Type of Business Employment Dates (From - To) Weekly Starting Salary Weekly Last Salary Reason for Leaving Name of Supervisor Describe the work you did. 2   Name & Address of Company & Type of Business Employment Dates (From - To) Weekly Starting Salary Weekly Last Salary Reason for Leaving Name of Supervisor Describe the work you did. 3   Name & Address of Company & Type of Business Employment Dates (From - To) Weekly Starting Salary Weekly Last Salary Reason for Leaving Name of Supervisor Describe the work you did. PERSONAL REFERENCES (Not former Employers or Relatives)

Name & Occupation Address Phone Number

RECORD OF EDUCATION

School Name and Address of School Last Year Completed Did You Graduate? Elementary YES NO High YES NO College YES NO Other YES NO

May we telephone you to follow up on this application at home? YES NO

If yes, what is the best time to call?

May we telephone you to follow up on this application at work? YES NO

If yes, what is the best time to call?

What is your business telephone number?

PLEASE READ AND SIGN BELOW

The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application may result in my dismissal. I further understand that this application is not and is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me. I understand and agree that my employment is at-will and can be terminated by either party with or without notice, at any time, for any reason or no reason. No one other than an officer of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing and then only in a writing signed by an officer.

Signature (Type your name)

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