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Form: Employee Application
Step
1
of
4
25%
Name
First
Middle
Last
Phone
Email
Position Sought
Driver
Warehouse Associate
If unlisted, leave blank
Present Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Date Available
MM slash DD slash YYYY
Desired Salary
Are You Authorized to Work in the US?
Yes
No
Have you ever worked for Second Harvest?
Yes
No
If so, when?
MM slash DD slash YYYY
Start Date
If so, when?
MM slash DD slash YYYY
End Date
Have you ever been convicted of a Felony or misdemeanor other than a minor traffic violation that has not been expunged by court?
Yes
No
If yes, please explain:
Education History
High School
Address
Did you graduate?
Yes
No
College
Address
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Did you graduate?
Yes
No
Degree or Certificate Completed
Other
Address
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Did you graduate?
Yes
No
Degree or Certificate Completed
Employment History
Are you Presently Employed?
Yes
No
List Any Professional Licenses you hold that are applicable to the position applied for:
Type
License #:
Expiration Date:
Add
Remove
Previous Employment
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Reason for Leaving
May we Contact your Previous Supervisor for a Reference?
Yes
No
Previous Employment
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Reason for Leaving
May we Contact your Previous Supervisor for a Reference?
Yes
No
Previous Employment
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Reason for Leaving
May we Contact your Previous Supervisor for a Reference?
Yes
No
References
Full Name
First
Last
Relationship
Company
Phone
Address
Full Name
First
Last
Relationship
Company
Phone
Address
Full Name
First
Last
Relationship
Company
Phone
Address
If you would like to upload a Cover Letter, Resume, or other Documents you may do so here:
Drop files here or
Select files
Max. file size: 100 MB.
Consent
(Required)
I have read, understood, and agreed to all statements listed below:.
- Second Harvest Food Bank of East Central Indiana is an Equal Opportunity Employer and as such will recruit and hire employees without regard to race or ethnicity, religion, national origin, gender identity or presentation, sexual orientation, age, political affiliation, veteran status, or disability except when physical condition is a bona fide occupational qualification. Second Harvest will not tolerate discrimination or harassment based on any of these characteristics.
- This application must be filled out in detail. Failure to complete all sections, or to sign this form, will result in its being returned for completion, causing delay or possible disqualification.
- I understand and agree that acceptance of this application in no way obligates Second Harvest to employ me or that there are any positions available.
- As an applicant for employment with Second Harvest, I have furnished information for use in determining my qualifications for employment. I hereby authorize Second Harvest to conduct a thorough background investigation to further support the statements contained herein.
- I understand and agree that if employed, I will be an employee “at will” and will have the right to terminate my employment at any time, with or without notice and with or without cause, and that Second Harvest will have the same right.
- I hereby affirm that all statements made herein are true and correct to the best of my knowledge and understand that any misrepresentation may result in my being disqualified from further consideration or being terminated should I already be employed by Second Harvest.
By typing my name I affirm that the above is true.
(Required)
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Form: Employee Application
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