Personal Information:
 
Name:*
 
Address*
 
Phone number*
 
Email address*
 
Are you at least 18 years old?*
yes
no
 
Do you have a legal right to work in the United States?*
 
Have you applied to East Valley Feed and Tack in the past? If yes, when?*
 
Have you ever used another name that we would need to verify employment and education? If yes, indicate such name and date*
 
Have you ever been convicted of a crime (felony or misdemeanor), or entered a plea of guilty/no contest to a crime? If yes, state when, where, and nature of conviction*
 
Are you currently employed? If yes, may we contact your employer?*
 
Position:
 
Position for which you are applying?*
 
Salary/wage desired?*
 
What days/hours are you available to work? Please list any scheduling conflicts/obligations*
full time
part time
temporary
split shift
weekends
overtime
 
I am not able to work on the following days/times:*
 
When would you be able to start working?*
 
How did you hear about this job?*
current employee
friend
relative
social media
walk in
 
Do you have a valid driver's license?*
yes
no
License #*
License class*
License state*
License expiration date*
 
Have you been given a job description, or have the requirements been explained to you?*
yes
no
 
Do you understand the job requirements?*
yes
no
I have not had the duties explained to me
 
Can you perform any or all of the job functions for the position you are seeking, either with or without reasonable accommodations?*
yes
no
 
Can you meet the attendance standards of our company, which requires all employees to report to work on time for all scheduled days or shifts?*
yes
no
 
Skills and training:
 
Describe speicialized training, skills, or research*
 
List any certifications, and/or professional licenses, if any, and where registered*
 
Office/business equipment and software qualified or trained to use*
 
Please indicate any language skills you possess (other than English)*
 
Emlpoyment Experience:
 
Begin with your present or last job. Account for all periods of time, including military experience, and periods of unemployment and the nature of your activities. Since we will make every effort to contact previous employers, the correct contact information is appreciated. The following must be completed in detail. Resumes are not accepted in lieu of this information
 
Employer*
Address*
Phone number*
Job title*
Supervisor's name and title*
Date employed*
Employment type
Full time
Part time
Starting salary*
Ending salary*
Key reponsibilities:*
Reason for leaving?*
 

 
Employer*
Address*
Phone number*
Job title*
Supervisor's name and title*
Date employed*
Employment type
Full time
Part time
Starting salary*
Ending salary*
Key reponsibilities:*
Reason for leaving?*
 

 
Employer*
Address*
Phone number*
Job title*
Supervisor's name and title*
Date employed*
Employment type
Full time
Part time
Starting salary*
Ending salary*
Key reponsibilities:*
Reason for leaving?*
 
Education and training
 
High school
School name*
 
City, state, and zip*
 
Graduated
yes
no
in progress
 
Community college
School name*
 
City, state, and zip*
 
Dates attended*
 
Graduated
yes
no
in progress
 
College/university
School name*
 
City, state, and zip*
 
Dates attended*
 
Graduated
yes
no
in progress
 
References
Name*
 
Relationship*
 
Organization*
 
Phone number*
 

 
Name*
 
Relationship*
 
Organization*
 
Phone number*
 

 
Name*
 
Relationship*
 
Organization*
 
Phone number*
 
Resume
If you have a text resume that you'd like to submit, please paste it into the box below
 
Plain Text Resume*
 
Certification
Please read the following carefully and initial each section before digitally signing your application
 
I hearby certify that I have personally completed this application and that the answers given by me are true and complete, and that no material facts have been omitted. I understand that false statements appearing on this or any other employment form will be sufficient reason to end further consideration of the application and not hire me; if discovered after my employment such false statements will be sufficient reason for my dismissal regardless of the time that has elapsed.*
 
I authorize East Valley Feed & Tack to contact my references and to investigate my past employment, credit history, education credentials, driving record, and other employment related activities, without giving me prior notice of such disclosure. I agree to cooperate in such investigations and release those parties supplying such information to East Valley Feed and Tack from all liability or responsibility wtih respect to the information supplied*
 
I request, authorize, and consent to the procurement of an investigative consumer report and understand that it may contain information about my background, mode of living, character, personal characteristics, and general reputation. This authorization in original or copy format shall be valid for one year from the date dinicated next to my signature below. According to the Fair Credit Reporting Act, I will be notified if employment is denied because of information obtained from a Consumer Reporting Agency. Additionally, I understand that if requested within 60 days, I will be given a full and accurate disclosure as to the nature and substance of all information provided.*
 
I understand that submitting this application in no way assures me a position with East Valley Feed and Tack and that this application is no, and is not intended to be, a contract of employment, and compensation can be terminated, with or without cause, and with or without notice, at any time, and at the option of either East Valley Feed and Tack or myself. I further understand that no one other than the president or East Valley Feed and Tack has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing*
 
If employed by East Valley Feed and Tack I agree to abide by the rules, policies, and procedures of East Valley Feed and Tack, and any rules, policies, or procedures that may become effective after employment. I understand that my initial and continued employment may be contingent upon the successful completion of a medical exam, and such exam may include drug and alcohol screening. I understand that East Valley Feed and Tack belives strongly in a drug free work environment and agree to abide by the drug and alcohol policies during my employment.*
 
Please digitally sign and date*
Location:*