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Employment Application
Applicant Information
Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Telephone Number
*
Email Address
*
Position
Position applying for
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Full Time
Part Time
Temporary
How did you hear about this position?
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Days you are available to work
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Hours or shift you are available to work
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If needed, are you available to work overtime?
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Yes
No
Date you can start if hired
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MM slash DD slash YYYY
Do you have reliable transportation to and from work?
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Yes
No
Desired hourly salary
*
Personal Information
Do you have any friends, relatives, or acquaintances working for Kitchen Cubes?
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Yes
No
Please list your friends, relatives, or acquaintances working for Kitchen Cubes.
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Person's Name
Relationship to You
Are you 18 years old or older?
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Yes
No
Are you a U.S. Citizen or approved to work in the United States?
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Yes
No
Can you provide supporting documents as proof of citizenship or legal status?
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Yes
No
Do you have any condition which would require job accommodations?
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Yes
No
Please describe the accommodations required.
*
(Note: Kitchen Cubes complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.)
Have you ever been convicted of a criminal offense (felony or misdemeanor)?
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Yes
No
Please state the nature of the crime(s), when and where convicted and disposition of the case.
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying.
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Education and Training
High School or General Education (GED) Test Passed?
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Yes
No
College/Business/Vocational School/Specialized Training
Name
Location (City, State)
Year Graduated
Degree Earned
Military
Are you a member of the Armed Services?
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Yes
No
What branch?
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Rank when discharged?
*
Years served?
*
What military skills do you possess that would be an asset for this position?
*
Previous Employment
Please list below your previous emploiyers.
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Employer Name
Job Title
Employer Address
City, State, Zip
Supervisor Name
Employer Telephone
Dates Employed
Reason for Leaving
May we contact this employer?
Resume
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Accepted file types: pdf, Max. file size: 10 MB.
Truth Disclaimer
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I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal.
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