Application for Employment

Fields marked with * are mandatory.

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

 

Address:
Social Security # (Optional)
Date
Position(s) applied for or type of work desired:
Type of employment desired
Date you will be available to start work:
Are you able to meet the attendance requirements?
Do you have any objection to working overtime if necessary?
Can you travel if required by this position?
Have you ever been previously employed by our organization?
Can you submit proof of legal employment authorization and identity?
If you are under 18, can you furnish a work permit if it is required?
Have you ever been convicted of a crime?
If yes, please explain (a conviction will not automatically bar employment):
Driver’s license number (Required):
How were you referred to us?
When may we contact your current employer?

Employment History

Please provide all employment information on your past four employers starting with the most recent.
   
Employer:
Position held:
Address:
Telephone #:
Immediate supervisor and title:
Dates employed: from
to
Salary:
Job summary:
Reason for leaving:
 
Employer:
Position held:
Address:
Telephone #:
Immediate supervisor and title:
Dates employed: from
to
Salary:
Job summary:
Reason for leaving:
 
Employer:
Position held:
Address:
Telephone #:
Immediate supervisor and title:
Dates employed: from
to
Salary:
Job summary:
Reason for leaving:
 
Other Skills and Qualifications
Summarize any job-related training, skills, licenses, certificates, and/or other qualifications:

Educational History

List school name and location, years completed, course of study, and any degrees earned:
High school:
College:
Technical Training:
Other:
   

Professional References

List 3 references names, telephone numbers, and years known (do not include relatives):
Name
Telephone
Years known
 
Name
Telephone
Years known
 
Name
Telephone
Years known

Voluntary Affirmative Action Data

PLEASE NOTE: COMPLETION OF THIS SECTION IS VOLUNTARY
We consider all applicants for positions without regard to race, religion, color, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve/national guard, or any other similarly protected status. We also comply with all applicable laws governing employment policies and do not discriminate on the basis of any unlawful criteria.

In an effort to comply with government record keeping, reporting, and other legal obligations that may apply, we request that you complete the applicant data survey. Providing the information is strictly voluntary. Failure to provide it will not subject you to any adverse personnel decisions or actions. You cooperation is appreciated.

 
Sex:
Please select one of the following Equal Employment Opportunity Identification Groups:
Referral Source:
 

I hereby authorize Logan Beverage Inc. to contact, obtain, and verify the accuracy of information contained in this application from all-previous employers, educational institutions, and references. I also hereby release from liability Logan Beverage Inc. and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either the employer or I can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

 
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