The information given on this form is for company use only. It will be to the applicant's advantage to answer each question fully and accurately. The use of this form does not indicate that there are any positions open and does not in any way obligate the company. Please enter your information in the fields and click Submit below.
Identification:
Email Address:
Full Name: (First, Middle, Last)
Present Address: (Street, City, State, Zip)
Social Security Number:-- Telephone Number:
Are you a United States Citizen? Yes   No
If no, are you authorized by the U.S. Immigration Service to accept employment?
Yes   No   (Visa Number: )
NOTE: Proof of citizenship or immigration status will be required upon employment.
Have you been convicted of a felony, or released from prison in the past 10 years?
Yes   No
Note: A yes answer does not automatically disqualify you from employment. The nature of the offense, date, and type of job you are applying for will be considered. If yes, please explain.
Referred By:
Advertisement Relative Walk in
Friend Employment Agency Other
Have you applied for a job here before? Yes   No   When:
Have you ever worked here before? Yes   No   When:
Are you presently employed? Yes   No
    May we contact your present employer? Yes   No

Position Wanted:
What job are you applying for?
Type of Employment: Full Time   Part Time   Seasonal   Other:
    If seasonal, how long?
On what date could you start work?
Willing to work shifts? Yes   No      Hours Available:
Days Available: Sun  Mon  Tue  Wed  Thur  Fri  Sat
Will you travel if the job requires it? Yes   No

Education:
If not a high school graduate, insert number of school years completed. If no degree has been obtained, insert college credit hours completed.
Name Location Dates Attended
From/To:		 Major Course Degree Grade Avg.
High School
College
Graduate School
Other: Special or Technical Training

Employment History:
Note: Starting with present or most recent employer, account for periods of employment for the last ten years. You may use an extra sheet if more space is necessary.
Employer Name:
Address (City, State):     Telephone:
Title of Your Position:
Immediate Supervisor's Name and Title/Dept.:
Date started:      Date ended:
Salary start:      Salary end:
Reason for leaving:
Describe Work Performed: ( Work can be described through your resume.)
Employer Name:
Address (City, State):     Telephone:
Title of Your Position:
Immediate Supervisor's Name and Title/Dept.:
Date started:      Date ended:
Salary start:      Salary end:
Reason for leaving:
Describe Work Performed: ( Work can be described through your resume.)
Employer Name:
Address (City, State):     Telephone:
Title of Your Position:
Immediate Supervisor's Name and Title/Dept.:
Date started:      Date ended:
Salary start:      Salary end:
Reason for leaving:
Describe Work Performed: ( Work can be described through your resume.)

Activities:
List any extra curricular activities or honors received that might be helpful in considering your application. You may exclude activities which would reveal your age, sex, race, religion, national origin, ancestry, disability, or other protected status.

Special Skills:
Summarize special job-related skills and qualifications acquired from employment or other experience.

Employment Agreement:
I understand that if employment is offered it is not for any definite period of time and is subject to termination with or without cause by the company or at my own election at any time. I further understand that my employment would be at-will, and that no statements have been made indicating otherwise, and that this policy cannot be changed except in a written document signed by an authorized officer of the company.
If accepted, I must conform to all company rules and regulations as made known at the time of employment or any other time thereafter; to perform all duties assigned to me to the best of my ability; and to be responsible to the company for any loss or damage of any tools, keys, or any other property entrusted to my care.
The compensation paid to employees for services covers inventions and improvements pertaining to the business of the company and that, as a further condition of employment in certain classes of work, it will be necessary to sign an agreement relating to the assignment of inventions to the company.
I certify that the facts contained in this application are true and complete to the best of my knowledge and understanding that, if employed, falsified statements on this application shall be sufficient reason for discharge from the service of the company.

Applicants Initials:   Date:

Authority to release information:
TO WHOM IT MAY CONCERN:
I hereby authorize the company or its representative bearing this release, or copy thereof, to obtain any information in my file pertaining to my employment, credit or educational records, including, but not limited to academic achievement, attendance, athletic, personal history, and disciplinary records, medical records, and credit records. I hereby direct you to release such information upon request of the bearer. This release is executed with full knowledge and understanding that the information is for the company's official use.
I hereby release you, as custodian of such records, and any school, college, university, or other educational institution, hospital, or other repository of medical records, credit bureau, lending institution, consumer reporting agency or related business establishment from any and all liability for damages of whatever kind. Should there be any questions as to the validity of this release, you may contact the Human Resource Department at jobs@jwoperating.com.

Date:
Initials:   Printed Name:

Attachments:
You may upload up to two files to attach to the application. (i.e. Resume)

Click Here to attach files.