ONLINE APPLICATION

APPLICANT INFORMATION:
First Name:
 Middle Name:
 Last Name:
Street Address:
 City:
 State:
Zip Code:
 E-mail Address:
 Phone Number:
Social Security No:
 Date Available:
 Desired Salary:
Are you a citizen of the United States?
If no, are you authorized to work in the U.S.?
Have you worked for this company before?
If yes, when?
Have you ever been convicted of a crime?
If yes, please explain:
Do you have a drivers license?
 Driver's License No.:
State of Issue:
 Expiration date:
Which Drivers License Category Applies?
Have you had any accidents in the past three years?
If so, how many?
Have you had any moving violations in the past three years?
If so, how many?
POSITION/AVAILABILITY:
Position Applying for:
How many hours can you work weekly?
Can you work nights?
Are you applying for Full-Time, or Part-Time?
Which days/hours are you available to work? Example Monday 12PM - 3PM
EDUCATION:
High School:
Address:
From:
From:
Did you graduate ?
Degree:
College:
Address:
From:
To:
Did you graduate ?
Degree:
Other:
Address:
From:
To:
Did you graduate ?
REFERENCES: Please list three professional references.
Full Name: Relationship:
Company:
 Phone:
Address:
  
Full Name: Relationship:
Company:
 Phone:
Address:
  
Full Name: Relationship:
Company:
 Phone:
Address:
  
PREVIOUS EMPLOYMENT:
Job Title:
 Company:
Street Address:
 City:
 State:
Zip Code:
 E-mail Address:
 Phone Number:
Supervisor:
 Starting Salary:
 Ending Salary:
From:
 To:
 Reason for Leaving:
May we contact your previous supervisor for a reference?
 
Job Title:
 Company:
Street Address:
 City:
 State:
Zip Code:
 E-mail Address:
 Phone Number:
Supervisor:
From:
 To:
 Reason for Leaving:
May we contact your previous supervisor for a reference?
Job Title
 Company:
Street Address:
 City:
 State:
Zip Code:
 E-mail Address:
 Phone Number:
Supervisor:
From:
 To:
 Reason for Leaving:
May we contact your previous supervisor for a reference?
MILITARY SERVICE
Branch:
 From:
 To:
Rank at Discharge:
 Type of Discharge:
If other than honorable, explain:
Application Form Waiver
PLEASE READ CAREFULLY
In exchange for the consideration of my job application by James Vending, Inc., (hereinafter called "the Company"), I agree that:

Neither the acceptance of this application nor the subsequent entry to any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefits plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of the Company, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President/ General Manager of the Company. Both the undersigned and Company may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures, and such changes may include reduction in benefits.

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.

I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.

I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be probationary for a period of 90 days, and further that any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.
Date:
 Electronic Signature:
PLEASE REVIEW

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, or disability. We assure you that your opportunity for employment with the Company depends solely on your qualifications. Take this time to go back through and make sure every applicable field is filled in to the best of your knowledge.

Thank you for completing this application and for your interest in our business! After you have checked over all your fields submit your application.
          
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