Employment Application

APPLICANT NOTE

This application shall be considered active for no more than 90 days. After that time, applicants will be required to resubmit a completed application. Federal and state laws prohibit discrimination and employment because of sex, age, race, color, religious creed, marital status, national origin, ancestry, citizenship, liability for service in the armed forces of the United States, disability or any other protected class. This applicant understands that neither this document nor any offer of employment constitutes an employment contract unless a specific document is executed in writing by the employer and employee.

We are an equal opportunity employer and do not discriminate against any applicant because of race, color, religion, sex, national origin, age disability, sexual orientation, marital status, or any other class protected by federal, state, or local law.

Today's Date*
MM slash DD slash YYYY
Email*
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone
Cell Phone*
Are you 18 years or older?*
- Yes
- No
In order to comply with Federal and State child labor requirements, applicants offered employment will be required to show proof of minimum age, and may be required to provide us with employment permits as applicable.
Have you ever worked in a related field?*
- Yes
- No
Where and when?*
AVAILABILITY
For which position are you applying?*
What date can you start?*
MM slash DD slash YYYY
Referred by?
Which category do you prefer?*
- Full time
- Part time
Please list the days / hours you are available
How did you hear about Flexible Fundamentals?
EDUCATION
High School Name*
High School City / State*
Degree*
College*
College City / State*
Degree*
Other
List all with location and degrees
JOB RELATED SKILLS

Note: Do not fill out any part of this section you believe to be non-job related.
List languages in which you are fluent:
Do you have a valid drivers license?*
- Yes
- No
Has your license ever been suspended or revoked?*
- Yes
- No
Please explain
Professional License #*
If a job-related License is listed above, do you currently have a pending investigation on the License?*
- Yes
- No
If yes, please exlain
IMMIGRATION

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document upon hire.
EMPLOYMENT HISTORY
MOST RECENT EMPLOYER:*

Name
Employer Address*
Street Address City State / Province / Region ZIP / Postal Code
Employer Phone*
Dates employed:*
Supervisor’s name:*
Job title:*
Duties :
Reason for leaving :*
Are you currently working for this employer?*
- Yes
- No
If yes, may we contact?
- Yes
- No
SECOND MOST RECENT EMPLOYER:*

Name
Employer Address*
Street Address City State / Province / Region ZIP / Postal Code
Employer Phone*
Dates employed:*
Supervisor’s name:*
Job title:*
Duties :
Reason for leaving :*
PROFESSIONAL REFERENCES

Include only individuals familiar with your work ability and are not already listed above. Do not include relatives.
Reference #1 Name*
First Last
Reference #1 Address*
City State
Reference #1 Phone*
Reference #2 Name*
First Last
Reference #2 Address*
City State
Reference #2 Phone*
Reference #3 Name*
First Last
Reference #3 Address*
City State
Reference #3 Phone*
CRIMINAL OFFENDER RECORDS INFORMATION

Flexible Fundamentals conducts criminal background investigations prior to hiring, transferring or promoting employees and/or contractors. All applicants for positions should be aware that if Flexible Fundamentals obtains correctional offender information regarding an applicant, it may consider such information in its hiring decision. This does not mean that individuals with negative correctional offender histories are disqualified from securing positions with the company. Flexible Fundamentals has the discretion, however, to apply any weight it deems reasonable to correctional offender information when considering applicants and it may base adverse decisions upon such criminal offender history. Flexible Fundamentals, if it obtains correctional offender information concerning an applicant, will provide the applicant with a copy of the correctional offender record it has obtained. Any applicant t who believes his or her correctional offender information is incorrect may contact the Massachusetts Department of Criminal Justice information Services, Constituent Assistance and Research Unit at (617)660-4640 to obtain information regarding the process for the correction of such information.

AVAILABILITY

EDUCATION

JOB RELATED SKILLS

IMMIGRATION

EMPLOYMENT HISTORY

PROFESSIONAL REFERENCES

CRIMINAL OFFENDER RECORDS INFORMATION