Employment Application
* Phone Number

* Please enter your Full Name (First, Middle, Last)

* Street Address

* City

* Zip Code

* Are you 18 or older?

If no, What is your Age?

* Are you a U.S. Citizen or an Alien authorized to work in the U.S.?

* Have you ever worked or applied here before?

If Yes, please specify Date.

* Position

* Date you can start

* Pay Desired

* Are you currently employed?

* If yes, can we contact your present employer?

* Total hours available per week?

* Day and Time Available each day(for example: Sunday 1pm-midnight)?

* How did you hear of the job?

* Do you have reliable transportation?

* Do you know anyone who works here?

If so, Who?

* Do you have Health Problems or physical limitations that preclude you from performing any work for which you are being considered?


If Yes, what can be done to accommodate your limitation?

* Have you ever been convicted of a Felony?

If Yes, Describe

* Grammar School: Name and Location

* Number of years attended?

* Did you graduate?

* High School: Name & Location

Number of years attended?

* Did you Graduate?

Course of study

College: Name & Location

Number of years attended?

Did you Graduate?

Course of Study?

Trade, Business or other school: Name and Location

Number of years attended?

Did you Graduate?

Course of study?

MOST RECENT JOBS: Name and address of employer



Reason for leaving

Most Recent Job 2: Name and Address of employer



Reason for leaving

REFERENCES: Please list at least 3 References

Persons not related who you have known at least one year.

In case of emergency: Name, Address and Phone Number

By submitting to this you agree to the following policies.

Employment Application I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for my dismissal after employment.

I authorize and request all persons, businesses and organizations to release any requested information to Troy Lanes related to verification of employment, academic achievement, licenses, general background and personal character. All information will be propriety and kept confidential and will not be provided to any parties other than representatives of this Company. I am aware that I have the right to request the nature and scope of the results and preparation of any reports concerning myself or my background. I authorize a Photostat of this release to be considered as effective and valid as the original.

I understand that I may be asked to submit to a drug test as a condition of employment.

I understand and agree, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.

I have read or had read to me this release form and I understand, consent and agree to authorize the execution of this release in full by my digital signature on this date.

Please be patient, it might take awhile for your inquiry to be submitted. Do not click Submit more than once.