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Online Employment Application



 

*First Name:
*Last Name:
*I am applying for::
*Address:
*City:
*State:
*Zip Code:
*Phone:
*Email:
*Are you seeking part or full time employment?:
*What is your expected pay rate?:
*Date available for employment::
*How did you hear about the position?:
*Are you legally authorized to work in the U.S.?:
*Have you been convicted of a criminal offense?*:
If yes, what was the charge and the date?:
*Have you ever been employed here before?:
If yes, dates of employment :
*Do you have sewing experience?:
Describe sewing experience if applicable:
*Do you smoke?**:
*Name of High School:
*Highest grade completed:
Name of College attended:
Years of college completed:
Graduate school attended:
Years of graduate school completed:
*Professional Reference 1 (no relatives):
*Reference 1 - Company:
*Reference 1 - Relationship:
*Reference 1 - Address:
*Reference 1 - Phone:
*Professional Reference 2 (no relatives):
*Reference 2 - Company:
*Reference 2 - Relationship:
*Reference 2 - Address:
*Reference 2 - Phone:
*Professional Reference 3 (no relatives):
*Reference 3 - Company:
*Reference 3 - Relationship:
*Reference 3 - Address:
*Reference 3 - Phone:
*Previous Employment - Company 1:
*Previous employer's address:
*Previous employer's phone:
*Supervisor:
*Job title:
*Starting wage:
*Ending wage:
*Responsibilities:
*Employed from (date):
*Employed to (date):
*Reason for leaving:
*May we contact your supervisor?:
*Previous Employment - Company 2:
*Previous employer's address:
*Previous employer's phone:
*Supervisor:
*Job title:
*Starting wage:
*Ending Wage:
*Responsibilities:
*Employed from (date):
*Employed to (date):
*Reason for leaving:
*May we contact your supervisor?:
*A conviction record will not necessarily be a bar to employment and factors such as your age at the time of the offense, the seriousness and nature of the violation and the nature of the job for which you are applying will be taken into account.
**Fire-Dex does not hire smokers.

By clicking submit you agree to the following statements:

I understand that this application does not constitute an employment contract or an offer for employment. I further understand that if I am offered a position of employment that my employment will be “at will” and that either I or the company may terminate the employment at any time for any reason with or without cause and with or without notice. I also understand that no individual representative of the company other than the president, may alter this employment relationship either verbally or in writing. I understand that I must at all times abide by the company’s rules and regulations.
I authorize the investigation of all statements contained herein and authorize the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have personal or otherwise. I further release and agree to hold harmless the company and all parties providing information from all liability for any claim or damage that may result from furnishing such information to you.

I certify that the information I have give on this application is true and complete to the best of my knowledge and belief. I understand that any false information provided on this application or at the time of any interview(s) may cause for immediate discharge.