Application for Employment

PLEASE NOTE THAT ON-LINE APPLICATIONS MUST BE COMPLETED AND SUBMITTED IN LESS THAN ONE HOUR OR THE WEB-SITE WILL NOT BE ABLE TO PROCESS THEM.

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We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or any other protected status.

Please use the tab key throughout the form


How Did You Learn About Us?


*First Name
  		*Last Name
  		Middle Initial
*Address
 
*City
  		*State
 *Zip Code
 
Home Phone Number
()  - 
Cell Phone Number
()  - 
Other Phone Number
()  - 
Social Security Number
On what date would you be available to work?
 /  / 
Minimum Salary Desired

If you are under 18 years of age, can you provide required proof of your eligbility to work?

Have you ever filed an application with us before?

If Yes, give date:  /  / 

Have you ever been employed with us before?

If Yes, give date:  /  / 

Are you currently employed?

May we contact your present employer?

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
Proof of citizenship or immigration status will be required upon employment.

Are you available to work:

 

Are you currently on "lay-off" status and subject to recall?

Have you ever been convicted of a crime?

If Yes, please explain: (500 Characters Max)

Employment History

Start with your present or last job. Include any job-related military service assignments and volunteer activities.
You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other
protected status.

If presently employed, may we contact your employer?
Company Name  Telephone #  ()  - 
Company Address 
City  State  Zip 
Position Held Duties (500 Characters Max)
Supervisor Hire Date  /  /  Leave Date  /  / 
Starting Pay
Ending Pay Reason For Leaving (250 Characters Max)
Company Name  Telephone #  ()  - 
Company Address 
City  State  Zip 
Position Held Duties (500 Characters Max)
Supervisor Hire Date  /  /  Leave Date  /  / 
Starting Pay
Ending Pay Reason For Leaving (250 Characters Max)
Company Name  Telephone #  ()  - 
Company Address 
City  State  Zip 
Position Held Duties (500 Characters Max)
Supervisor Hire Date  /  /  Leave Date  /  / 
Starting Pay
Ending Pay Reason For Leaving (250 Characters Max)
Company Name  Telephone #  ()  - 
Company Address 
City  State  Zip 
Position Held Duties (500 Characters Max)
Supervisor Hire Date  /  /  Leave Date  /  / 
Starting Pay
Ending Pay Reason For Leaving (250 Characters Max)

Education

Elementary School
School Name
Location
Years Completed
Diploma / Degree
(250 Characters Max)


High School
School Name
Location
Years Completed
Diploma / Degree
(250 Characters Max)

Describe Course of Study: (250 Characters Max)

Undergraduate College / University
School Name
Location
Years Completed
Diploma / Degree
(250 Characters Max)
Describe Course of Study: (250 Characters Max)

Graduate / Professional
School Name
Location
Years Completed
Diploma / Degree
(250 Characters Max)
Describe Course of Study: (250 Characters Max)

Additional Education Information

Describe any specialized training, apprenticeship, skills, and extra-curricular activities.
(750 Characters Max)

Describe any honors you have received.
(750 Characters Max)

State any additional information you feel may be helpful to us in considering your application.
(500 Characters Max)



Indicate any foreign languages you can speak, read and / or write.
(75 Characters Max for all)
  Fluent Good Fair
Speak
Read
Write





List professional, trade, business, or civic activities and offices held.
You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, handicap, or other.
(1000 Characters Max)


References

List name, address and telephone number of three references who are not related to you. References should include at least one former/current co-worker.

Name: 
Address: 
City: 
State: 
Phone:  ()  - 
Years Known: 
 


Name: 
Address: 
City: 
State: 
Phone:  ()  - 
Years Known: 
 


Name: 
Address: 
City: 
State: 
Phone:  ()  - 
Years Known: 
 



Have you ever had any job-related training in the United States military?

  
If Yes, please describe: (500 Characters Max)
Are you physically or otherwise unable to perform the duties of the job for which you are applying?

  


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

(750 Characters Max)

You may utilize the following form to add attachment files from your computer to your application for employment. Simply, click on the "Browse" button next to each attachment and select a file from your hard drive to attach. You may add up to two files to your application. The files may be cover letters or any other relevant documents that may assist us in evaluating your application.

Attachment #1:

Attachment #2:


I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or conduct unless such a change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

 
*Signature of Applicant

    

The Plymouth Place ensures a drug free work place. EOE m/f/d/v
 
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