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APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer - All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, sexual orientation, genetic information, or any other characteristic protected by law.
Step 1 of 6
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PERSONAL INFORMATION
Incomplete information could disqualify you from further consideration. Please complete all fields.
Name
*
Date
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Country
--Select--
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
E-mail Address
*
Mobile Phone #
*
Home Phone # (if any)
Are you eligible to work in the U.S?
*
Yes
No
Are you 21 years of age or older?
*
Yes
No
Have you ever been terminated from employment or asked to resign by an employer?
*
Yes
No
Please provide company name(s) and details
*
What days and hours are you available to work?
*
EMPLOYMENT DESIRED
Position Desired
*
Route Sales Representative
HR Business Partner
Which area are you applying for?
*
Prescott/Prescott Valley
Verde Valley
Flagstaff
Winslow
Holbrook
Show Low
Date you can start
*
Do you know anyone who works for our company?
Yes
No
Who do you know?
How did you hear about us?
EDUCATION
Have you completed high school or received a GED?
*
Yes
No
What other education do you have? (List colleges attended, trade schools, degrees or certifications earned)
Do you have any special skills, experience or training that relate to the position you applied for?
*
Yes
No
Explain.
Rate Your Computer Skills:
*
Exceptional
Average
Minimal
EMPLOYMENT HISTORY
Include your last ten (10) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time.
Incomplete information could disqualify you from further consideration.
Previous employment history
*
CRIMINAL BACKGROUND AND DRIVING HISTORY
In the last seven (7) years, have you been convicted, pleaded guilty or no contest to, or received a deferred adjudication, for a felony or a misdemeanor more serious than a minor traffic infraction?
*
Yes
No
If yes, explain:
*
(A criminal history is not an absolute bar to employment. An individual assessment will be made in all cases.)
If you are applying for a position that involves driving, you will need to provide evidence of three (3) years of a clean driving record before being offered employment.
APPLICANT ACKNOWLEDGMENT Please read carefully before signing.
I understand that filling out this Employment Application does not mean that I am being offered employment. This Employment Application does not create a contract between the company and me for employment or any other benefit. I understand that no promise or guarantee of employment is binding, unless made by the President of Pee Wee Distributing Company.
I understand that the company will rely, in part, on the information I provided in this Employment Application when considering whether to hire me. I verify that I provided complete and accurate information. If the company discovers at any time that I provided false information or omitted important information when completing this Employment Application or during the interview process, I understand that my application will not be considered or, if I am working for the company, I may be dismissed from employment.
I authorize Pee Wee Distributing Company to contact anyone it deems appropriate to verify the information I have provided or to investigate my background, past performance and suitability for employment. I authorize those people contacted by the company to discuss my work, past performance and suitability for employment.
If I am offered employment, I understand that the offer may be conditioned upon successful results from a pre-employment drug test and background check. I also understand that if I am hired, I will be employed "at will," meaning that I am not hired for any definite length of time and either I or the company can end my employment at any time for any reason.
Signature
*
Date
*