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Application for Employment:
We are an equal opportunity employer. We comply with all applicable Federal, State, and Local laws concerning discrimination in employment. No question in this application is intended to elicit information in violation of any such law nor will any information obtained in response to any question be used in violation of any such law.

Position (s) applied for:

Date of application:

Applicant Information:

If you are under 18, and it is required, can you furnish a work permit? yes no
If no, please explain:

Have you ever been employed here before? yes no
Are you legally eligible for employment in this country? yes no

Type of employment desired:?

Are you able to meet the attendance requirements for the position? yes no
Have you been convicted of a crime in the last (7) years? yes no

Do you have a current Driver's License? yes no

Previous Work Experience 1 - Include the following: Dates (From - To), Employer, Phone, Address, Summarize the nature of work performed and job responsibilities, Job title, Immediate supervisor and title, Reason for leaving, and Hourly rate/salary (Final $ per hour, week, month, year)

Work Experience 2 - Fill in the following information: Dates (From - To), Employer, Phone, Address, Summarize the nature of work performed and job responsibilities, Job title, Immediate supervisor and title, Reason for leaving, and Hourly rate/salary (Final $ hour, week, month, year).

Summarize any training, skills, licenses, and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

High School Record of Education - Name and location, years completed, did you graduate and course of study.

College Record of Education - Name and location, years completed, did you graduate, and course of study.

Other Record of Education - Name and location, years completed, did you graduate, and course of study.

First Reference:

Second Reference:

Third Reference:

Please explain in a short paragraph why you would be an asset to American Services, Inc.

To be completed by all applicants - Please read carefully before authorizing:

I certify that the information contained in this application and in any resume provided by me or any party representing my interests is correct and complete to the best of my knowledge. I understand that any false statements, misrepresentations or omissions made by me on this application or any supplement thereto, will be sufficient grounds for rejection of this application or discharge after employment.

I give the employer the right to obtain pertinent information concerning me from former employers and others, and I release all those providing or requesting such information from any liability that may arise by truthful disclosures or such investigations.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminated my employment at any time with or without cause and without prior notice, except as may be required by law. this application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no representative of the employer, other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.

I understand it is the company's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA.

I also understand that if I'm hired, I will be required to provide proof of identity and legal work authorization. Your Social Security and Drivers License numbers will be required if asked to be interviewed.

Your full name and date acknowledges you have read and agree to the material above. Do you agree?
yes no