Employment application

🔒 For your security, do NOT enter your Social Security Number anywhere on this application. We will collect it in person only after an offer of employment.

Fields marked with an asterisk are required.

Contact information

First name:

Last name:

Email:

Phone:

Street address:

City:

State:

ZIP code:

Position, pay, and availability

Position applying for:

Desired pay:

e.g. $15/hr

Date available to start:

Desired employment type:

Availability (days / shifts you can work):

Days/shifts you can work, schedule constraints.

Work eligibility

We ask only the job-eligibility questions this application requires.

Are you legally authorized to work in the United States?

Are you 18 years of age or older?

Education

Highest education level:

Education details:

Schools attended, subjects, honors.

Licenses and certifications

Forklift certified:

CDL holder:

CDL class (if any):

Other licenses / certifications:

Work history

List up to three prior employers. Reminder: do not enter your Social Security Number.

Employer 1

Employer:

Job title:

Start date:

e.g. 03/2022

End date:

e.g. 05/2024 or Present

Duties / responsibilities:

Reason for leaving:

May we contact this employer?

Employer 2

Employer:

Job title:

Start date:

e.g. 03/2022

End date:

e.g. 05/2024 or Present

Duties / responsibilities:

Reason for leaving:

May we contact this employer?

Employer 3

Employer:

Job title:

Start date:

e.g. 03/2022

End date:

e.g. 05/2024 or Present

Duties / responsibilities:

Reason for leaving:

May we contact this employer?

References

List up to three people we may contact. Reminder: do not enter your Social Security Number.

Reference 1

Name:

Relationship:

Phone:

Reference 2

Name:

Relationship:

Phone:

Reference 3

Name:

Relationship:

Phone:

Additional information

How did you hear about us?

Resume (PDF or Word — optional):

Anything else you'd like us to know? (optional):

Certification and signature

For your security, do NOT enter your Social Security Number anywhere on this application. We will collect it in person only after an offer of employment.

I certify that the information provided on this application is true and complete to the best of my knowledge.

Signature (type your full legal name):

Typed full name as signature.