Employment Application

Name *

First

Last *

Last

Email *

Home Phone

Mobile Phone

Address *

Address

City

State/Province

Zip/Postal

Are you eligible to work in the U.S?

Yes

No

(If offered employment, you will be required to provide documentation to verify employment)

Are you at least 18 years or older?

Yes

No

(If no, you may be required to provide authorization to work.)

Can you work any shift?

Yes

No

Shift and times?

Can you work overtime, including weekends?

Yes

No

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?

Yes

No

EMPLOYMENT DESIRED

Date you can start:

Employment Desired *

Full-time

Part-time

Full- or Part- time

Position desired

Hourly Rate/Salary desired

Are you currently employed?

Yes

No

If so may we inquire of your present employer?

Present employer info:

REFERRAL SOURCE

How did you hear about us? *

Walk In

Referral

Other

Have you ever worked for Aux Ops before? *

Yes

No

Dates worked for Aux Ops

Location

Date started

Date ended

Add Remove

Do you know anyone who works for our company? *

Yes

No

Who works for our company you know?

EDUCATION:

Please indicate education or training which you believe qualifies you for the position you are seeking.

High School:

Number of Years Completed

1

2

3

4

Diploma

Yes

No

G.E.D.

Yes

No

List High School(s) City/State

College and/or Vocational School: 

Number of Years Completed

1

2

3

4

Major

Degrees Earned

List School(s) City/State

Other Training or Degrees:

List School(s) City/State

Course

Degree or Certificate Earned

PROFESSIONAL LICENSE OR MEMBERSHIP

Type of License(s) Held

(There is no for you to disclose membership in professional organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, marital status, veteran status or any other protected status.)

EMPLOYMENT:

List last employer first, including U.S. Military Service or include a resume. 

May we contact your present employer? *

Yes

No

If any employment was under a different name, indicate name:

Prior Employer(s)

Employer

Location

Job Title

Date started

Date ended

Supervisor

Duties

Reason for Leaving

Add Remove

Explain any gaps in work history:

Other Skills:

Do you have any special skills?

Computer Skills:

References

Type of reference

Professional

Personal

Name

Phone

Company

Title

Relationship

Add Remove

Attach Resume

Required upload size: .002MB – 4.2MB

If you have a document that provides additional details, please attach that document here. If you need to submit only a resume application you may do so from another form on the previous page.

Please read carefully before signing.

Aux-Ops is an equal opportunity employer. Aux-Ops will never discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Aux-Ops to hire me. If I am hired, I understand that either Aux-Ops or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Aux-Ops has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Aux-Ops true and complete information on this application. No requested information has been concealed. I authorize Aux-Ops to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Please check before signing:

I have read carefully; the paragraphs above, before signing.

Signature

Clear

Date

THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE SIGNED/DATED ABOVE.

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