Careers @
T-Shotz

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is
used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

Applicant name:

Date:

Position(s) applied for or type of work desired:

Your Address: (optional)

City:

State:

Zip:

Phone:

Email:

Type of employment desired:
Full TimePart TimeTemporary

Date you will be available to start work:

How were you referred to us?

Employment History

Please provide all employment information for your past three employers starting with the most recent

May we contact your current employer?
YesNo

Most Recent (or current) Employer

Employer:

Position:

Address:

Phone:

Immediate supervisor and title:

Date Started:

Date Ended:

Salary:

Job Summary:

Reason for leaving:

Second Most Recent Employer

Employer:

Position:

Address:

Phone:

Immediate supervisor and title:

Date Started:

Date Ended:

Salary:

Job Summary:

Reason for leaving:

Third Most Recent Employer

Employer:

Position:

Address:

Phone:

Immediate supervisor and title:

Date Started:

Date Ended:

Salary:

Job Summary:

Reason for leaving:

Other Skills and Qualifications

Summarize any job-related training, skills, licenses, certificates, and/or other qualifications:

Educational History

List school name and location, years completed, course of study, and any degrees earned

High school:

College:

Technical Training:

Other:

References

List 3 references names, telephone numbers, and years known (do not include relatives or employers):

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information
contained in this application from all previous employers, educational institutions, and references. I also
hereby release from liability the potential employer and its representatives for seeking, gathering, and
using such information to make employment decisions and all other persons or organizations for
providing such information.

I understand that any misrepresentation or material omission made by me on this application will be
sufficient cause for cancellation of this application or immediate termination of employment if I am
employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application
does not constitute an agreement or contract for employment. Accordingly, either I or the employer can
terminate the relationship at will, with or without cause, at any time, so long as there is no violation of
applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against
a qualified individual with a disability because of that person’s need for a reasonable accommodation as
required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and
legal work authorization within three days of being hired. Failure to submit such proof within the required
time shall result in immediate termination of employment.

Have you read and do you agree to the paragraphs above?
YesNo

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

Have you read and do you agree to the statement above?
YesNo

Name:

Date: