Application for Employment
Please Fillout and Press The Submit Button Below
Equal access to programs, services and employment is available to all persons. Those applicants requiring accommodation to the application and/or interview process should contact a representative of the Human Resources Department.
Position Applying For: Date: 7/23/2008
Name:      
Last First Middle
Address :      
Street/Apt. City State Zip Code
Telephone : ()   Social Security Number:  
If your are under 18, can you furnish a work permit?
Yes No
Have you ever been employed here before?
Yes No
Are you legally authorized to work in this country?
Yes No
Type of employment desired
Full-Time Part-Time Temp
Are you able to meet the attendance requirements of the position?
Yes No
Have you been convicted of a crime in the last (7) years?
Yes No
(Such conviction may be relevant if job-related, but does not necessarily bar you from employment.)
If yes, please explain:
Date available for work:
Driver's License Number : State:
(Only if job applied for requires use of automobile in daily tasks)

Previous Employment
Please list your last four employers, assignments or volunteer activities, starting with the most recent, including military experience.
From:
 To:
Employer
 Telephone
Job Title
 Address
 City
 State
 Zip
Immediate Supervisor and Title
 Brief summary of work performed and job responsibilities
Reason for leaving
 Hourly rate/salary
Starting $ per   Ending $ per
From:
 To:
Employer
 Telephone
Job Title
 Address
 City
 State
 Zip
Immediate Supervisor and Title
 Brief summary of work performed and job responsibilities
Reason for leaving
 Hourly rate/salary
Starting $ per   Ending $ per
From:
 To:
Employer
 Telephone
Job Title
 Address
 City
 State
 Zip
Immediate Supervisor and Title
 Brief summary of work performed and job responsibilities
Reason for leaving
 Hourly rate/salary
Starting $ per   Ending $ per
From:
 To:
Employer
 Telephone
Job Title
 Address
 City
 State
 Zip
Immediate Supervisor and Title
 Brief summary of work performed and job responsibilities
Reason for leaving
 Hourly rate/salary
Starting $ per   Ending $ per

Skills and Qualifications
Summarize any training, skills, licenses, certificates and/or characteristics of yourself that may qualify you as being able to perform functions for the position which you are applying.


Educational Background
Name and Location Number of Years Completed Did you Graduate? Course of Study
High School
 
 
 
College
 
 
 
Other (i.e. Trade School)
 
 
 

References
Name Telephone Years Known

Cover Sheet Upload (optional):
(.doc, .txt or .pdf)


Resume Upload (optional):
(.doc, .txt or .pdf)




Consent and Release Form

I attest to the truth and accuracy of all information I have provided on this application and it is understood and agreed that any misrepresentation by me or omissions of fact on this application will be sufficient cause for rejection of my application and/or termination of my employment, if I have become employed.

I give the company the right to investigate all references and to secure additional information about me, if job-related. I hereby release the company and its representatives from any liability for seeking such information, as well as all other persons, corporations or organizations for furnishing such information to the company.

This company is a "Drug Free Workplace" and it is understood that all offers of employment are conditional. The company required those all-eligible applicants to participate in a pre-employment drug-testing program. An application will not be processed further unless the eligible applicant agrees to participate in the test. Failure to sign the Consent and Release Form will disqualify me from any consideration for employment. Further, I voluntarily consent to take a pre-employment screening and background testing.

The company is an equal opportunity employer and will not base hiring decisions on race, sex, national origin, religion, disability, age, or any other protected characteristic under applicable local, state, or federal laws. The company does not discriminate in employment and no question on this application is used or intended to be used for the purpose of limiting or excluding any applicant's consideration for employment on any basis prohibited by applicable local, state or federal law.

This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that the company is an "employer at-will" and that if I become employed by the company just as I will be free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand it is this company's policy not to refuse to hire a qualified individual with a disability because of this person’s need for an accommodation that would be required by the ADA.
Digital Signature of Applicant Date


Contact Information
Phone: (800) 728-8432
Email: jobs@bhmanagement.com