Personal Identification Work Preference Availability for Work
Shift or Time of Day (Part Time Only)
Will you work overtime on occasion? Yes No Will you work extra days in the week if necessary? Yes No Do you have any commitments or agreements with another employer that might affect your employment? Yes No Do you have any ongoing obligations or other personal commitments that would affect your work schedule? Yes No Are you presently employed? Yes No Do you need to give advance notice to your present employer? Yes No Personal Would you be willing to take a drug/alcohol screening before and/or after employment as a condition of employment? Yes No Are you at least 18 years old? Yes No If hired, can you furnish proof that you are authorized to work in the U.S.? Yes No Prior Events Have you ever worked for, or applied for work at this company before? Yes No Have you ever been discharged for cause? Yes No Have you ever been convicted of any law violation, except a minor traffic violation? Yes No (A criminal record does not automatically bar employment) Have you ever been disciplined for absenteeism and/or tardiness? Yes No Education & Training High School or GED *Only the highest level of education attained is required College/University Technical/Vocational Employment Record Upload Resume (Optional)
APPLICANT AGREEMENT: (Read carefully before signing) All information provided by me is true and correct to the best of my knowledge. I understand omissions or misrepresentations may result in rejection of my application or, if employed, may result in subsequent dismissal. I hereby authorize any former employer, person, school, firm or corporation listed hereon, including this MCHC, to answer any and all questions related to employment and agree to release from liability and hold all persons harmless for giving any and all truthful information within their knowledge or records. I understand this is a preliminary application and not a contract to employ me. Furthermore, in the event I am employed, my employment shall be completely voluntary and may be terminated at will at any time by either myself or MCHC. I understand that no one other than the company president has authority to enter into any employment agreement to the contrary. I agree to take a drug/alcohol test and background screening as a condition of employment. I agree to comply with all rules of MCHC as a condition of employment. In the event MCHC advances me money or other things of value, I agree to repay MCHC and also that any amount still owing may be deducted from my final paycheck. Submit Thank you for your submission!