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If necessary for the job, I am able to work overtime.
I am legally eligible for employment in the U.S.
I can work the following shifts
Are you able to perform the essential functions of the position with or without accomodations?
I can provide a valid Colorado Driver's License.
I am seeking permanent employment.

EMPLOYMENT HISTORY

List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.

MILITARY

Are you a Veteran?

SKILLS & QUALIFICATIONS

REFERENCES

List two personal references who are NOT relatives of former supervisors.

OTHER

Have you ever been convicted of a crime? (Other than minor traffic violations)

INFORMATION TO THE APPLICANT

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. 

If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or drug test, or to sign a conflict of interest agreement and abide by its terms. I understand and agree to the information shown above. 

Your Signature

Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no effect on your application for employment.

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