Employment Application - ValleyWideBeverage

APPLICANT INFORMATION

Name*

First Middle Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

E-mail*

Date of Application*

Position Applied For*

Applying for:*

Full-time
Part-time
Seasonal

Date Available for Work*

Are you over the age of 18?*

Yes
No (If no, you may be required to provide authorization to work.)

Have you ever worked for this company?*

Yes
No

Do you have legal right to work in the United States?*

Yes
No

Do you now, or will you in the future, require immigration sponsorship for work authorization (e.g., H-1B)?*

Yes
No (If hired, verification will be required consistent with federal law.)

EDUCATION

High School or G.E.D. Equivalent

School Name and Location*

Course of Study or Major*

Years Completed*

Graduated?*

Yes
No

Details

College or University

School Name and Location

Course of Study or Major

Years Completed

Graduated?

Yes
No

Details

Vocational or Trade School

School Name and Location

Course of Study or Major

Years Completed

Graduated?

Yes
No

Details

Other (including military training)

School Name or Location

Course of Study or Major

Years Completed

Graduated?

Yes
No

Details

EMPLOYMENT HISTORY

List employment experience, starting with the most recent or current employer (attach separate sheets if necessary). You may include as part of your employment history any verified work performed on a volunteer basis. Resumes may not be substituted in lieu of completing the following employment information.

Current (Most Recent) Employer

Employer Name*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Position Held*

Primary Responsibilities*

From*

To*

Previous Employer

Employer Name

Phone

Address

Street Address Address Line 2 City State ZIP Code

Position Held

Primary Responsibilities

From

To

Previous Employer

Employer Name

Phone

Address

Street Address Address Line 2 City State ZIP Code

Position Held

Primary Responsibilities

From

To

Previous Employer

Employer Name

Phone

Address

Street Address Address Line 2 City State ZIP Code

Position Held

Primary Responsibilities

From

To

OTHER QUALIFICATIONS

Please list any other qualifications that you have and which you believe should be considered.

BACKGROUND INFORMATION

For the purpose of verifying information on this application, have you ever worked or attended school under a different name at any of the organizations you have listed?*

Yes
No

If yes, specify name

Should you receive a conditional offer from the Company, a background verification inclusive of a criminal check will be performed by a third party vendor, in accordance with federal, state and local law. The Company will also perform an individualized assessment regarding your criminal check based upon the nature and gravity of the offense, time passed since the offense occurred, and the direct and adverse relationship between prospective job duties and the offense. The Company will inform you of the results and will provide you with an opportunity to respond within (5) business days. The Company reserves the right to re-evaluate your candidacy and rescind your conditional offer after you have been given a chance to respond. Should you have any questions regarding this process, contact your Recruiter.

PROFESSIONAL REFERENCES

List three professional references (other than those listed as current/former supervisor) that we may contact:

Name*

Phone*

Email*

Type of Acquaintance*

Name*

Phone*

Email*

Type of Acquaintance*

Name*

Phone*

Email*

Type of Acquaintance*

TO BE READ AND SIGNED BY APPLICANT

I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.

I understand, where permissible under applicable state and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must receive a negative result for illegal drugs before being permitted to commence work with the Company.

I understand, where permissible under applicable state and local law, I may be subject to a pre-employment medical examination after receiving a conditional offer of employment, and must meet the qualifications for the position, with or without reasonable accommodation, before being permitted to commence work for the Company.

I hereby certify that the information given by me is true in all respects. I authorize the Company and its representatives to contact my prior employers and all others for the purpose of verification of the information I have supplied and release same from any liability resulting from the information released. I authorize employers, schools and other persons named on this application to provide any information or transcripts requested.

I understand employment with the Company is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

I understand that I will be required to possess a current and valid California driver's license and provide proof of automobile insurance if my job requires me to drive in the course of my work.

I expressly understand and agree that, if employed, my employment, having no specified term, is based upon mutual consent and may be terminated at will, with or without cause, by either party (the Company or me) without prior notice to the other, unless otherwise prohibited by law.

I understand that no representation, whether oral or written, by any representative or agent of the Company, at any time, can constitute an implied or expressed contract of employment. I further understand no representative or agent of the Company has the authority to enter into an agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other terms or condition of employment other than in a document signed by the CEO or an authorized representative.

I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment or interview(s) can result in disqualification for employment consideration or, if hired, may be grounds for termination from the company. I also understand that I am required to abide by all rules and regulations of the Company.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. My signature indicates that I have read and agree with the above statements.

Applicant's Signature*

Date*

Applicant's Name (printed)*

Name

This field is for validation purposes and should be left unchanged.