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Home585-266-3060
ONLINE EMPLOYMENT APPLICATION
All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws.
APPLICANT INFO
Applicant Name:
Address:
Apt:
City:
State:
Zip:
Email:
Phone:
ADDITIONAL QUESTIONS
Position(s) Applied For:
Referral Source:
Minimum Required Annual Salary:
Are You Currently Employed?
On lay-off and subject to recall?
Previously Worked Here?
If Yes, When:
Previously Applied Here?
If Yes, When:
Are you 18 years of age or older?
If you are under 18, can you provide required proof of your eligibility to work?

Are you authorized to work lawfully in the United States?
Note: in compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.
WORK AVAILABILITY
When can you start?

Can Work Full-Time?
Can Work Part-Time?
Can Work Shifts?
Can Work Temporarily?
Willing To Work Overtime
Can Work Shift 1?
Can Work Shift 2?
Can Work Shift 3?
WORK HISTORY
Most Recent Employer:
Phone:
Address:
Supervisor:
Job Title:
When Employed:
Responsibilities:
Reason For Leaving:

May we contact your previous supervisor for a reference?


Next Most Recent Employer:
Phone:
Address:
Supervisor:
Job Title:
When Employed:
Responsibilities:
Reason For Leaving:

May we contact your previous supervisor for a reference?


Next Most Recent Employer:
Phone:
Address:
Supervisor:
Job Title:
When Employed:
Responsibilities:
Reason For Leaving:

May we contact your previous supervisor for a reference?
EDUCATION
High School:
Address:
Years Attended:
Did you graduate?
Degree:


College:
Address:
Years Attended:
Did you graduate?
Degree:


Other:
Address:
Years Attended:
Did you graduate?
Degree:

Enter any additional information about yourself/education/certifications:
REFERENCES
Please list three. Make sure that the phone number and email address are current.
Full Name:
Company:
Email Address:
Phone:
Relationship:

Full Name:
Company:
Email Address:
Phone:
Relationship:

Full Name:
Company:
Email Address:
Phone:
Relationship:
APPLICANT CERTIFICATION
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company. I authorize the release of information about me by all past employers, education institutions, and law enforcement agencies and release any and all parties from any and all liability which may result from supplying such information.

I understand this application is in no way intended as an employment contract or agreement.

By submitting this application, I certify that the answers given herein are true and complete to the best of my knowledge.
Upload Resume (optional):