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Maxwell's Job Application

We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability. 

Date of application *
Date of application
PERSONAL INFORMATION
Name *
Name
Date of birth *
Date of birth
Phone *
Phone
Address *
Address
GENERAL INFORMATION
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation? *
Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.) *
EDUCATION & TRAINING
Graduated
Graduated or Degree
SKILLS & AVAILABILITY
Date you can start *
Date you can start
You may wish to list significant experience, interests & accomplishments gained while working as a volunteer or as a hobbyist that may be useful in the position (s) you are seeking. Names or organizations designating religion, race, etc. need not be mentioned.
EMPLOYMENT HISTORY
Starting with your PRESENT or MOST RECENT EMPLOYER list in consecutive order ALL EMPLOYMENT for at least the past FOUR employers. If currently employed, may we contact your employer?
Job History 1
Address
Address
Date Start
Date Start
Date End
Date End
Job History 2
Address
Address
Telephone
Telephone
Date start
Date start
Date end
Date end
Job History 3
Address
Address
Telephone
Telephone
Date start
Date start
Date end
Date end
READ CAREFULLY:
I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
Date *
Date