Butcher's Block | Big Bear Lake, CA | Employment Application

Credit Application

Employment Application

BUTCHER’S BLOCK & BUILDING MATERIAL - EMPLOYMENT APPLICATION
An Equal Opportunity Employer

Date

Last Name

First Name

Present Address

City

State

Zip Code

Permant Address (If different from Present Address)

City

State

Zip Code

Business Phone

Home Phone

Employment Desired

Position Applying For:

Are You Applying For:

Regular Full-Time Work?

Yes

Regular Part-Time Work?

Yes

Temporary Work, e.g. summer or holiday work?

Yes

Other than time off for reasons related to your religion, a disability or a medical condition, are there any days or times when you are unavailable to work?

If applying for part-time work, during what period of time will you be available?

Date

Would you be available to work overtime, if necessary?

Yes

If hired, what date can you start work?

Personal Information

How did you hear about our company and this job opening?

Have you ever applied to or worked for Butcher's Block and Building Materials before?

Yes

If Yes, when

Why are you applying for work at Butcher's Block and Building Materials?

If hired, would you have a reliable means of transportation to and from work?

Yes

Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.)

Yes

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?

Yes

If no, describe the functions that cannot be performed.

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

We may refuse to hire relatives of present employees if doing so could result in actual or potential problems in supervision, security, safety, or morale, or if doing so could create conflicts of interest

Education, Training, and Experience

High School

No. of Years Completed

Degree/Diploma

High School Address

City

State

Zip Code

Did You Graduate?

Yes

College/University

No. of Years Completed

Degree/Diploma

College/University Address

City

State

Zip Code

Did You Graduate?

Yes

Vocational/Business

No. of Years Completed

Degree/Diploma

Vocational/Business Address

City

State

Zip Code

Did You Graduate?

Yes

Healthcare Training

No. of Years Completed

Degree/Diploma

Healthcare Training Address

City

State

Zip Code

Did You Graduate?

Yes

Do you have any other experience, training, qualifications, or skills that you feel make you especially suited for work at Butcher's Block and Building Materials?

Yes

If so, please explain:

Answer the following questions if you are applying for a professional position:

Are you licensed/certified for the job applied for?.

Yes

Name of license/certification:

Issuing State

License/certification number:

Has your license/certification ever been revoked or suspended?.

Yes

If yes, state reason(s), date of revocation or suspension, and date of reinstatement.

Employment History

List below all present and past employment starting with your most recent employer (last five years is sufficient). You must complete this section even if attaching a resume.

Name of Employer

Type of Business

Phone Number

Your Supervisor's Name

Address

City

Start Date of Employment

State

Zip Code

End Date of Employment

Your Position and Duties

Reason for Leaving

Current Employer?

Yes

May we contact this employer for a reference?

Yes

Name of Employer

Type of Business

Phone Number

Your Supervisor's Name

Address

City

Start Date of Employment

State

Zip Code

End Date of Employment

Your Position and Duties

Reason for Leaving

May we contact this employer for a reference?

Yes

Name of Employer

Type of Business

Phone Number

Your Supervisor's Name

Business Address

City

Start Date of Employment

State

Zip Code

End Date of Employment

Your Position and Duties

Reason for Leaving

May we contact this employer for a reference?

Yes

References

List below three persons not related to you who have knowledge of your work performance within the last three years.

Reference 1 Last Name

First Name

Address

City

State

Phone Number

Occupation

Zip Code

No. of Years Acquainted

Reference 2 Last Name

First Name

Address

City

State

Zip Code

Phone Number

Occupation

No. of Years Acquainted

Reference 3 Last Name

First Name

Address

City

State

Phone Number

Occupation

Zip Code

No. of Years Acquainted

Please Read Carefully, Initial Each Paragraph and Sign Below

Initials

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Initials

I hereby authorize Butcher's Block & Building Materials to thoroughly investigate my
references, work record, education and other matters related to my suitability for employment (excluding criminal background information) unless otherwise specified above. I further authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

Initials

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the Company's designated representative.

Initials

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 form upon hire.

Butcher's Block & Building Materials will consider qualified applicants, including those with criminal histories, in a manner consistent with state and local "Fair Chance" laws.

Date

Applicant's Signature

Thanks for submitting your application!