Alabama Wing House
251.446.4000ing
Alabama Wing House
251-446-4000
PLEASE PRINT CLEARLY
Applicant Information Date _________________________
First Name____________________ Middle_______________ Last___________________
Social Security Number: _______________
Street Address: _________________________________ City/St/Zip ________________________________
Phone: _______________________________ Position(s) applied for: ______________________________
If hired do have a reliable means of transportation? ______ Describe: _________________________
Are you at least 18 years old? ________ Are you legally eligible for employment in the US? _____________
(Proof of US citizenship or immigration status required if hired)
Have you ever been convicted of a crime? ______ If yes, state the nature of the case and disposition of the case.
Please include dates and location. _______________________________________________________________
(Note: The existence of a criminal record does not constitute an automatic bar to employment)
Are you seeking full or part time employment? _______ List times you are NOT available to work: ____________
Are you willing to work overtime? Weekends? Holidays? __________, ____________, ____________
Are you currently employed? ____________ If hired when could you start? _____________
Have you ever been discharged or asked to resign from any position? _____ IF yes describe: _________________
Elementary Name of School: ______________ Level completed: ___________
High School Name of School: ______________ Level Completed: ___________
GED Name of School: ______________ Level Completed: ___________
Work History: (please begin with most recent)
1) Company ______________________________ Phone: ________________
Dates of Employment: From ________ to _________ Job Title: _________________________
Supervisor’s Name and Title: _________________ Describe Duties Briefly: ___________________________
Specific reason for leaving: ____________________________________________________________________
2) Company ______________________________ Phone: ________________
Dates of Employment: From ________ to _________ Job Title: _________________________
Supervisor’s Name and Title: _________________ Describe Duties Briefly: ___________________________
Specific reason for leaving: ____________________________________________________________________
May we contact employers listed above? __________
If not list employers you do not want us to contact and why: ________________________________________
I authorize this company to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge.
I specifically authorize and direct my current and former employers to supply employment-related infor-mation to this company and do hereby release my current and former employers from liability for providing information to this company.
Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer.
I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investigative report deemed necessary through various third party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations.
I hereby agree to submit to any drug test required of me, whether prior to my employment or if employed by this company at any time thereafter. If requested, I will take a post-job offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician.
I further understand this is an application for employment and that no employment contract is being offered. I understand that if I am employed, such employment is for an indefinite period of time and the company may change wages, benefits, and conditions at any time. My employment is at will. No individual with the company is authorized to change the employment-at-will status except an officer of the company, who may do so only in writing. I have read, understand, and agree to the above.
Applicant’s Signature Date __________________________________
Check over the foregoing application to make sure it is complete and signed.