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Job Application Form

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Your information
Name(Required)
First Last
Address(Required)
Street Address Address Line 2 City State ZIP Code
Phone(Required)
Email(Required)
Have you ever worked for our company?(Required)
- Yes
- No
Which location and department?
Previous employment start date
MM slash DD slash YYYY
Previous employment end date
MM slash DD slash YYYY
Are you 18 or older?(Required)
- Yes
- No
For what position are you applying?
Wages expected?
What type of work are you interested in?
- Permanent or full-time
- Part-time
- Seasonal
- Any of the above
Are you willing to work any or all of the following shifts?
- Night shift
- Holidays
- Saturdays
- Sundays
- Overtime when needed
- All of the above
- None of the above
When can you start?
MM slash DD slash YYYY
In what specific field has most of your experience been?
What special qualifications do you have?

Your employment history

List below, beginning with your most recent, all present and past employment
Employment #1
Company name of current/past employer(Required)
Company address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company phone number(Required)
Start date(Required)
MM slash DD slash YYYY
End date(Required)
MM slash DD slash YYYY
Describe in detail the work you did(Required)
Beginning hourly wage
Ending hourly wage
Reason for leaving(Required)
Name of supervisor(Required)
Employment #2
Company name of current/past employer(Required)
Company address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company phone number(Required)
Start date(Required)
MM slash DD slash YYYY
End date(Required)
MM slash DD slash YYYY
Describe in detail the work you did(Required)
Beginning hourly wage
Ending hourly wage
Reason for leaving(Required)
Name of supervisor(Required)
Employment #3
Company name of current/past employer
Company address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company phone number
Start date
MM slash DD slash YYYY
End date
MM slash DD slash YYYY
Describe in detail the work you did
Beginning hourly wage
Ending hourly wage
Reason for leaving
Name of supervisor
Employment #4
Company name of current/past employer
Company address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company phone number
Start date
MM slash DD slash YYYY
End date
MM slash DD slash YYYY
Describe in detail the work you did
Beginning hourly wage
Ending hourly wage
Reason for leaving
Name of supervisor
Employment #5
Company name of current/past employer
Company address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company phone number
Start date
MM slash DD slash YYYY
End date
MM slash DD slash YYYY
Describe in detail the work you did
Beginning hourly wage
Ending hourly wage
Reason for leaving
Name of supervisor
May we contact the employers listed above?(Required)
- Yes
- No
If not, indicate which one(s) you do not wish us to contact.(Required)
Would any of your former employers or references have your records under another name?(Required)
- Yes
- No
If yes, what name?(Required)

Your record of education
High school
Name of high school(Required)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Select last year completed(Required)
- 1st year
- 2nd year
- 3rd year
- 4th year
Did you graduate high school?(Required)
- Yes
- No
College
Name of college
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Course of study
Select last year completed
- 1st year
- 2nd year
- 3rd year
- 4th year
Did you graduate college?
- Yes
- No
List diploma or degree
Other (specify)
Name of school
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Course of study
Select last year completed
- 1st year
- 2nd year
- 3rd year
- 4th year
Did you graduate?
- Yes
- No
List diploma or degree
Your personal references

Not former employers or relatives
Reference #1
Name of reference(Required)
First Last
Occupation(Required)
Phone number(Required)
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference #2
Name of reference(Required)
First Last
Occupation(Required)
Phone number(Required)
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference #3
Name of reference(Required)
First Last
Occupation(Required)
Phone number(Required)
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Have you ever been convicted of a felony?(Required)
- Yes
- No
If yes, please explain(Required)
Have you ever been bonded?(Required)
- Yes
- No
Have you ever refused bond?(Required)
- Yes
- No
Give reasons(Required)
Do you have a valid Oklahoma Driver’s License?(Required)
- Yes
- No
A driving record is required before employment from the Department of Public Safety for positions which involve driving company vehicles.
Person to be contacted in case of an emergency(Required)
First Last
Phone(Required)
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

A Drug Test is required by the company after a conditional offer of employment is made, by a company physician and at company expense.
Consent(Required)
VOLUNTARY CONSENT AND RELEASE OF LIABILITY FOR DRUG/ALCOHOL TESTING
I understand that, for my protection and for the protection of others with whom I will be working, it is the Company’s policy to prohibit the use, possession, or sale of illegal or unauthorized drugs and alcoholic beverages on Company property or during working hours. Illegal and/or unauthorized drugs include the following: marijuana; narcotics; all other drugs not prescribed by a licensed physician for use by the person possessing them; and excessive quantities of prescribed drugs which may adversely influence performance or behavior.

My signature below constitutes voluntary consent to the Company’s request for me to provide urine and/or blood samples for alcohol and drug analysis. I fully understand that failure to cooperate with any request for a blood or urine sample for chemical analysis may result in discipline up to and including immediate discharge. I further agree to release and hold harmless the Company and its employees and agents from any and all liability whatsoever on account of, or arising from, this request to furnish a blood and/or urine sample, the testing of such sample, or disclosure of the results of any such chemical analysis.
I agree to voluntarily consent and release liability for the drug and alcohol testing as stated above.
Include your name here as the person giving consent(Required)
Name of person witnessing your consent(Required)
First Last
Date
MM slash DD slash YYYY
Additional comments for the employer to consider
You are not required to disclose information about physical limitations that you believe will not interfere with your capability to do the job. On the other hand, if you want the employer to consider special arrangements to accommodate a physical or mental impairment, you may identify that impairment in the space provided and suggest the kind of accommodation that you believe would be appropriate.
Application agreement and understanding(Required)
Please Read Carefully

1. Equal Employment Opportunity. Vox/Reid Printing is an equal opportunity employer. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age or physical or mental disability. This policy of non-discrimination extends to all terms, conditions and privileges of employment and to all personnel actions.

2. Authorization by Application. I authorized Vox/Reid to contact my former employers and references listed on this application, and I authorized such individuals and organizations to release information required by Vox/Reid Printing. The information I have supplied on this application and by way of any oral statements is true and accurate, and I understand that any intentional misstatement by me may result in immediate dismissal.

3. Employment at Will. In consideration of my employment, I agree to conform to the rules and regulations of Vox/Reid Printing as set forth in its employee handbook, and understand that my employment and compensation may be terminated with or without notice, at any time, at the option of either the Company or myself. I understand that no other company official has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing except by a written document dated and signed by myself and an officer of the Company. I also understand that the company’s policies contained in the employee handbook do not constitute a contract of employment and may be modified by management at any time.

I understand that this application will remain effective for a period of thirty (30) days from the date submitted, and, thereafter, that I must re-apply if I wish to continue to be considered for employment.
I agree to the statement above.
Digital sigature(Required)
Please include your name again that you are the applicant and certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Date of signature(Required)
MM slash DD slash YYYY

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