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Education

High SchoolCollegeTrade SchoolOther
High School





College





Trade School





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List three references who are not relatives or former employers:











List employers in chronological order with current or last employer listed first. Account for all periods of time including military service and periods of unemployment

Employer 1









Employer 2









Employer 3













PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING
  • I certify that all information provided in this employment application is true and complete. I understand that any false information
    or omission may disqualify me from consideration for employment and may result in my dismissal if discovered at a later day.
  • I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any
    person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful
    in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
  • I understand that I may be required to successfully pass a drug screening examination. If required, I hereby consent to a pre- and/or
    post- employment drug screen as a condition of employment.
  • I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-
    employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge
    my capability to do the work for which I am applying.
  • IF I AM EMPLOYED AT PEERLESS, I ACKNOWLEDGE THAT THERE IS NO SPECIFIED LENGTH OF EMPLOYMENT AND THAT THIS APPLICATION DOES NOT CONSTITUTE A CONTRACT FOR EMPLOYMENT. ANY SUCH EMPLOYMENT AGREEMENT MUST BE IN WRITING AND SIGNED BY BOTH THE PRESIDENT OF PEERLESS AND THE EMPLOYEE. ACCORDINGLY, EITHER I OR PEERLESS CAN TERMINATE MY EMPLOYMENT AT WILL, AT ANY TIME, WITH OR WITHOUT CAUSE.



An Equal Opportunity Employer

We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job related factors.

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