Employment Application

Please note that we do background checks and COVID-19 vaccination is required to work at 7 Mile House.

How were you referred to us:

Optional

Position Applying for:

Optional

APPLICANT DATA

Name:

First Name

Last Name

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile Phone:

(###)

###

####

Email:

Date Available to Start:

YYYY

Salary Requirements:

Social Security Number:

Birthdate:

YYYY

If you are under 18 years of age, can you provide a work permit?

If no, please explain:

Have you ever worked for 7 Mile House?

If yes, when?:

Are you legally allowed to work in the United States?:

If hired can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?:

Type of Employment Desired:

Full-Time

Part-Time

Temporary

Seasonal

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

If yes, state nature of the crime(s), when and where convicted, and disposition of the case:

Drivers License Number:

If applicable to position

State Drivers License Issued:

If applicable to position

Are you able to perform the essential functions of the job for which you are applying either with or without reasonable accommodation, (example: the ability to lift a maximum of 50 pounds, walking and standing for 8 hours, etc.)?

If no, describe the functions that cannot be performed:

EDUCATION AND HISTORY

Name & Location of High School:

Did you graduate?:

Name & Location of College:

If applicable

Years attended:

If applicable

Degrees Completed:

If applicable

Other Subjects Studied:

If applicable

Trade, Business or Correspondence School:

If applicable

Years Attended:

If applicable

Subjects Studied:

If applicable

Did you graduate?:

If applicable

SUMMARIZE YOUR SPECIAL SKILLS AND QUALIFICATIONS

Comment here:

PREVIOUS EMPLOYMENT

Job #1 (if applicable)

Dates of Employment:

FROM

YYYY

Company Name:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone:

(###)

###

####

Supervisor:

Title:

Responsibilities:

Starting Salary & Title:

Ending Salary & Title:

Reason for Leaving:

May we contact this employer for a reference?

Job #2 (if applicable)

Dates of Employment:

FROM

YYYY

Company Name:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone:

(###)

###

####

Supervisor:

Title:

Responsibilities:

Starting Salary & Title:

Ending Salary & Title:

Reason for Leaving:

May we contact this employer for a reference?

Job #3 (if applicable)

Dates of Employment:

FROM

YYYY

Company Name:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone:

(###)

###

####

Supervisor:

Title:

Responsibilities:

Starting Salary & Title:

Ending Salary & Title:

Reason for Leaving:

May we contact this employer for a reference?

Reference List

Name:

First Name

Last Name

Phone Number:

(###)

###

####

Company:

Association to Applicant:

Name:

First Name

Last Name

Phone Number:

(###)

###

####

Company:

Association to Applicant:

Name:

First Name

Last Name

Phone Number:

(###)

###

####

Company:

Association to Applicant:

"I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concering my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative 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, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

Full Name of Applicant:

First Name

Last Name

Date:

YYYY