Employment Application


Personal information:

Last Name:    First Name:    Middle:   

Email Address:  
Street Address:   City:   County:

State:         Zip:         Telephone:

Are you a U.S. Citizen or are you authorized by the INS to work in the United States? Yes No

Have you ever been convicted of any violation of federal or state law or Uniform Code of Military Justice other than minor traffic violations felony?
(An affirmative is not an automatic bar to employment) Yes No

If yes, please explain:

Have you ever been warned, disciplined or discharged for sexual harassment, fighting, assault or related offenses? Yes No

If yes, please explain:


Employment Desired:

What type of work are you applying for? Full-time Part-time

Hours available:         Position Applied For:

Have you received a description of the position or been made aware of the essential functions of the job that you are applying for? Yes No

Do you understand the requirements of this position? Yes No

If no, please explain:

Can you perform the essential functions of this position with or without (check one) reasonable accommodations? With Without

If you chose "with" accommodations, please describe the condition that limits your employment opportunities and explain your work limitations:

How did you hear of this opening?

Have you ever applied for employment here? Yes No        If yes, when?

Have you ever been employed by Old Hickory Furniture Company? Yes No

If yes, when?

Are you presently employed? Yes No        May we contact your present employer? Yes No

Will you relocate? Yes No

Are you willing to travel? Yes No     If yes, what percent? %

Date you can start?         Desired Salary $ per



Education

(Beginning with High School attended):
                       School                                                                  Degree                                               Location                        Grade Avg.          Major Course of Study

                         

                         

                         

                         

                         

                         

                         

                         


Please list any scholastic honors received and offices held in school:

Work Experience

(Please list employment starting with the most recent):

Company Name:      Address:

Telephone:

Date Started? Starting Wage $: Starting Position:

Date Ended?  Ending Wage $:   Ending Position: 

Name of Supervisor:      May we contact? Yes No

Responsibilities:

Reason for leaving:



Company Name:      Address:

Telephone:

Date Started? Starting Wage $: Starting Position:

Date Ended?  Ending Wage $:   Ending Position: 

Name of Supervisor:      May we contact? Yes No

Responsibilities:

Reason for leaving:



Company Name:      Address:

Telephone:

Date Started? Starting Wage $: Starting Position:

Date Ended?  Ending Wage $:   Ending Position: 

Name of Supervisor:      May we contact? Yes No

Responsibilities:

Reason for leaving:



Company Name:      Address:

Telephone:

Date Started? Starting Wage $: Starting Position:

Date Ended?  Ending Wage $:   Ending Position: 

Name of Supervisor:      May we contact? Yes No

Responsibilities:

Reason for leaving:



Skills

Please check all that apply and list years of experience:

Skill:                    Years of Experience:

Band Saw          
Table Saw         
Chop Saw         
Planer                
Jointer                
Drill Press           
Belt Sander         
CNC Router       
Spray Finish         
Fabric Cutting     
Upholstery          
Sewing               

Other Training:

In addition to your work education and work history, are there other qualifications, skills, or experience that we should consider?

References:

List three personal references, not related to you, who have known you for more than one year.

Name:      Telephone:      Years Known:     


Name:      Telephone:      Years Known:     


Name:      Telephone:      Years Known:     



Please read before signing:

I certify that all of the information provided by me on this application is true, correct and complete to the best of my knowledge and that I have withheld nothing, which, if disclosed, would alter the integrity of this application.

I understand that falsification, omission or misstatement of information may result in refusal to hire or if hired, dismissal from employment.

I authorize my previous employers, schools or persons listed as references to give any and all information regarding my previous employment or education record. I agree that Old Hickory Furniture Company and my previous employers will not be held liable in any respect if a job offer is not extended, or is withdrawn, or employment terminated because of false statements, omissions or answers made by myself on this application.

I understand that as a condition of employment I am required to take and pass a drug and alcohol screen. I also may be required during employment to take and pass medical and psychological tests including drug and alcohol screens.

I understand that Old Hickory Furniture Company has the right to search anything brought onto or removed from the premises of Old Hickory Furniture Company including desks, lockers, handbags, lunch bags and meal containers, brief cases and automobiles. In the event of any employment with Old Hickory Furniture Company, I will comply with all rules and regulations as set by Old Hickory Furniture Company in any communication distributed to the employees.

I understand that the benefits, rules and regulations of Old Hickory Furniture Company may be change, modified, deleted or added to by Old Hickory Furniture Company at any time at its sole option and without prior notice.

I understand that no representative of Old Hickory Furniture Company has any authority to enter into any agreement for employment for any specified period of time or to make commitments or promises, or to assure any benefit terms and conditions of employment unless such are made in writing and signed by the President of Old Hickory Furniture Company.

In compliance with the Immigration Reform and Control Act of 1986, I understand that I am required to provide documentation to Old Hickory Furniture Company, which verifies my right to work in the United States on the first day of employment.

I understand that employment at Old Hickory Furniture Company is "at will" which means that either I or Old Hickory Furniture Company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute and that all employment is continued on that basis. I hereby acknowledge that I have read and understand the above statements.



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