Freestore Foodbank | Donate Cincinnati | Charity Nonprofit

PERSONAL INFORMATION (required)

Last Name:

First Name:

Middle Initial:

Today's Date:

Address:

City:

State:

Zip Code:

Home Phone#:

Cell Phone:

Your Email:

EMPLOYMENT INQUIRIES (required)

Position Applying For:

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Available Start Date:

Salary Expected:

Per HourPer Year

Would you accept full time work?
YesNo

Would you accept part time work?
YesNo

Were you previously employed by us?
YesNo

If yes, when?:

Are you currently employed?
YesNo

Are you over 18?
YesNo

If no, can you provide proof of eligibility to work?:
YesNo

Have you ever been convicted of a felony?
YesNo

If yes, explain:

Are you legally eligible to work in the U.S.?
YesNo

If you are applying for a position that requires driving, do you possess a valid driver's license?
YesNoN/A

Will you now or in the future require sponsorship for employment visa status, (e.g., H-1B status)?
YesNo

If yes, explain:

Have you ever served in the U.S Armed Forces?
YesNo

If Yes, Dates of Duty:

Branch:

Applicable skills acquired:

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, disability or other protected status.

Employer Name:

Dates Employed:
From:

To:

Hourly Rate/Salary:
Beginning:

Ending:

Employer Address:

Supervisor's Name:

Supervisor's Title:

Telephone:

Reason for Leaving:

Position (Job Title):

Full time:
YesNo

Part Time:
YesNo

Work Performed:

May we contact this employer?
YesNo

Employer Name:

Dates Employed:
From:

To:

Hourly Rate/Salary:
Beginning:

Ending:

Employer Address:

Supervisor's Name:

Supervisor's Title:

Telephone:

Reason for Leaving:

Position (Job Title):

Full time:
YesNo

Part Time:
YesNo

Work Performed:

May we contact this employer?
YesNo

Employer Name:

Dates Employed:
From:

To:

Hourly Rate/Salary:
Beginning:

Ending:

Employer Address:

Supervisor's Name:

Supervisor's Title:

Telephone:

Reason for Leaving:

Position (Job Title):

Full time:
YesNo

Part Time:
YesNo

Work Performed:

May we contact this employer?
YesNo

EDUCATION BACKGROUND

High School:
1234

College/University:
1234

Graduate School:
1234

Vocational Training:
1234

Other:
1234

Other Qualifications:
Please list any special training or skills you have acquired. Include special machines or equipment you can operate, languages you can speak/read/write, and any other knowledge that has provided you with qualifying skills for the position.

REFERENCES (required)

Please provide information for three individuals, other than relatives or friends, whom we may contact for a professional recommendation.

Name:

Address:

Telephone:

Occupation:

Relationship to you:

Years Known:

Name:

Address:

Telephone:

Occupation:

Relationship to you:

Years Known:

Name:

Address:

Telephone:

Occupation:

Relationship to you:

Years Known:

Job Applicant's Agreement and Certification (required)

I certify that the information given by me in this application is true in all respects and agree that if the information is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements.

I authorize past employers, references, and any other persons to answer all questions asked concerning my eligibility, character, reputation, and previous employment record. I release all such persons from any liability for have furnished such information.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract. No promise regarding employment has been made to me, and I understand that no such promise or guarantee is binding upon you.

I understand that if employed, policies and rules that are issues are not conditions of employment and that the Freestore Foodbank may revise policies or procedures, in whole or in part, at any time. The Freestore Foodbank reserves and retains the right to make changes in terms and conditions of my employment as the Freestore Foodbank determines to be appropriate.

I understand that this application will be kept on file for one year from the date completed, after which time I would have to reapply in accordance with established company procedures.

I understand that if employed with the Freestore Foodbank, Inc. it is "at will" which means that my employment can be terminated with or without cause, with or without notice, and at any time at the option of either the Freestore Foodbank Inc. or myself, except as otherwise provided by law.

Applicant's E-Signature:

Date:

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