Employment Application | Jays Ultimate Produce and Dairy

Employment Application
Our company is an Equal Opportunity Employer that employs in compliance with all applicable laws. We do not discriminate because of sex, age, race, color religious creed, marital status, national origin, ancestry, mental of physical disability, citizenship, sexual orientation, or for any other reason prohibited by state or federal law.

Personal Information

Name *

Address *

City *

State *

ZIP *

Phone *

Social Security Number *

If under 18 years of age, do you have a work permit?

Yes

Are you a U.S. citizen, or an alien who has the legal right to remain and work in the U.S.? *

Yes

If you accept employment with us, the Federal Immigration Act of 1986 requires that you provide documents establishing your identity and work authorization.

Employment Desired

Position for which you are applying *

Hours *

Full Time

Part Time

Fill In

Date of Availability *

Can you travel if job requires it? *

Yes

Do you have a valid driver's license?

Yes

Have you ever applied for employment with this company? *

Yes

If yes, when?

In what position?

Please list any special skills you have

If you served in the military service of the United States did you recieve any special training which will help you perform the job for which you are applying? *

Yes

If yes, please describe

Education

Highest grade completed *

Years of college completed

Names of schools attended

Vocational or trade school

Course(s) of study

References

Name and occupation

Address

Phone

Name and occupation

Address

Phone

Name and occupation

Address

Phone

Prior Empoyers

Name & Address of Employer

Dates Employed

Supervisor

Position & Salary

Reason for Leaving

Name & Address of Employer

Dates Employed

Supervisor

Position & Salary

Reason for Leaving

Name & Address of Employer

Dates Employed

Supervisor

Position & Salary

Reason for Leaving

Name & Address of Employer

Dates Employed

Supervisor

Position & Salary

Reason for Leaving

Name & Address of Employer

Dates Employed

Supervisor

Position & Salary

Reason for Leaving

May we contact your employer at this time?

Yes

I understand that my employment will be on a 90 day introductory basis. My employment may be terminated, with or without cause or notice, at any time, at my option or that of the company. I understand that no management representative has any authority to enter into any agreement for continuing employment of any specific period of time which is contrary to the forgoing without written approval of the owner. I give the company permission to contact all or any of my previous employers and references and authorize them to provide all information requested of them by this company. I authorize you to obtain, use and rely upon that information in relation to my application. A have provided truthful and complete responses to all inquiries in the application and understand the discovery of any falsification or omission constitutes a ground for immediate dismissal. If employed by Jay’s Ultimate, I will abide by its rules and regulations, which I understand are subject to change by the company.

Date

Signature

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It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment. Any employer who violates this law shall be subject to criminal penalties and civil liability.