• Yes
  • No
  • Yes
  • No
  • Yes
  • No
  • Part Time
  • Full Time
  • Temporary
  • Yes
  • No
  • Yes
  • No
  • Some
  • Yes
  • No
  • Typing
  • Computer Experience
  • Cash Register Experience
  • Other Office Experience
  • Yes
  • No
  • Yes
  • No
  • Yes
  • No
  • Yes
  • No
  • Yes
  • No
Please list three references that are not relatives or former employers:
I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading, or otherwise incorrect statements made on this application form or during interviews may be grounds for my immediate discharge. I nearby authorize the Company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications. I also give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I nearby waive my right to bring any cause of action against these individuals for defamation, invasion of privacy or any other reason because of their statements. I agree that, if I am employed, I will abide by all the rules and regulations of the Company. I understand that the taking of drug and alcohol tests, when given pursuant to company policy, are a condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination. I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express consent of the President of the Company. I also understand that my employment is "at-will" and may be terminated by myself or by the company at any time for any reason or no reason at all; with or without prior notice.