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Home585-266-3060
ONLINE EMPLOYMENT APPLICATION
Applicants are considered for all positions without regard to any protected category, including but not limited to race, color, religion, gender, national origin, age, disability, martial status, sexual orientation, citizenship, veteran status, or presence of a non-job related medical condition or handicap.
APPLICANT INFO
Applicant Name:
Address:
Apt:
City:
State:
Zip:
Email:
Phone:
ADDITIONAL QUESTIONS
Position(s) Applied For:
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:
At Least 18 Years Of Age?
If No, State Age:

*Under the International Traffic and Arms Regulation's definition, a US Person is defined as someone who is either a US citizen or a Legal, Permanent Resident Alien with a current, valid Green Card.
Under this definition, are you a US Person?
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?
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:
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?
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.
Security Question:
Upload Resume (optional):