In the pursuit of

Service excellence

Application for Pathways

Qualified applicants receive equal consideration. No question is asked for the purpose of excluding any applicant due to race, color, national origin, religion, age, sex, disability,veteran status, or any other characteristic protected under local, state or federal law. WE ARE AN EQUAL OPPORTUNITY EMPLOYER.

How did you hear about us?

Do you have a valid FL driver’s license?

If your answer is yes, would you sign an authorization form allowing us to check your driving record?

List names of relatives or friends currently in our employment

Employment History

Please list your complete employment history. List present or most recent employer first. Use an additional page, if necessary.

Employer
Employed (mo./Yr.) From: To:
Type of work performed
Present or last salary
Reason for leaving

Employer
Employed (mo./Yr.) From: To:
Type of work performed
Present or last salary
Reason for leaving

Education

Schools
Name/Location
Circle Last Yr. Completed
Major Courses
Diploma/Degree

High School

College

Business or Trade

If you served in the United States Armed Forces, briefly describe the skills you acquired:

Personal Information

Are you legally authorized to work in the U.S.

Will you now or in the future require sponsorship for employment visa status (e.g. H-1B visa status)?

Note: you will be required to furnish documents to verify your eligibility for employment in accordance with the Immigration Reform and Control Act and your employment is contingent upon furnishing such documents.

Have you worked here before?

If yes, please provide dates.

Have you applied here before?

Are there any days, shifts or hours you will not work?

If yes, please provide days and hours you cannot work.

Will you work overtime if required?

Are you at least 18 years of age?

Have you ever been convicted of a crime or are there any pending charges against you?

(Aconviction does not automatically disqualify youfromemployment)

Do you have the ability to perform all essential job functions of the position(s) for which you are applying with or without accommodations?

If no, please explain.

If an accommodation is needed, please explain how you would perform the tasks, and what accommodation you require.

Please summarize special skills, expertise or qualifications acquired from employment or other experience, or provide any other additional information you feel may be helpful in considering your application.

Are you presently employed?

If so, may we contact your present employer?

If hired, when would you be available to start working?

References

I certify that the answers given by me to the foregoing questions and statements are true and correct to the best of my knowledge without consequential omissions of any kind. I agree that the Company shall not be held liable in any respect if my employment is rejected or subsequently terminated because of false statements, answers or omissions made by me in this application. I understand that any misleading or incorrect statements may render this application void, and if employed, may lead to employment termination.

I agree to submit to any alcohol or drug screen or other tests as warranted by circumstances at the discretion of the Company.

If I am employed and I fail to return any company issued property, I hereby authorize the Company to deduct from earnings due me at the time, the value of such property.

I also agree to furnish the personal tools customarily required for the position for which I am applying.

I also voluntarily and knowingly authorize the companies, schools or persons named above to give any information requested regarding my former employment, character and qualifications. I hereby voluntarily and knowingly fully release and discharge , absolve, indemnify, and hold harmless said companies, schools or persons from any and all liability for any damages for issuing this information, except for the malicious and willful disclosure of derogatory facts concerning my employment made for the express purpose of preventing me from obtaining employment, which the party disclosing such facts knows to beuntrue.

In consideration of my employment, I agree to conform to the rules and regulations of this organization. My employment and compensation can be terminated with or without cause and with or without notice, at any time, at the option of either my employer ormyself.