Lexington Employment Application Lexington, KY, Employment Application Personal Information FIRST Name * LAST Name * Phone * Email * Present Address * Present Address Street 1 Street 1 Street 2 Street 2 City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip/Postal Zip/Postal Are you 21 years or older? * Yes No Social Security Number * Employment Sought What position are your applying for? * Date Available To Begin Work * Applying For * Full-Time Part-Time Either Availability * Monday Tuesday Wednesday Thursday Friday Saturday Sunday Which shifts are you available to work? * Mid-Day (~12-4) Evening (~4-8) Late Night (~8-midnight) Times are an approximation only Education Do You Hold A High School Diploma or GED Certificate? * Yes No Highest Level of Education Completed? * High SchoolAssociate'sBachelor'sMaster'sDoctoralOther Highest Level of Education Completed? List Any Additonial School or Training You Have Taken * Employment History (1/3) Employer Name * From (Month/Year) * To (Month/Year) * Position Held * Supervisor's Name * Contact Info * Position * Part-Time Full-Time Hourly/Salary Pay * Reason for Leaving * Employment History (2/3) Employer Name From (Month/Year) To (Month/Year) Position Held Supervisor's Name Contact Info Position Part-Time Full-Time Hourly/Salary Pay Reason for Leaving Employment History (3/3) Employer Name From (Month/Year) To (Month/Year) Position Held Supervisor's Name Contact Info Position Part-Time Full-Time Hourly Pay Reason for Leaving Miscellaneous Are you authorized to work in the United States? * Yes No Are you willing to undergo a background check, in accordance with local law/regulations? * Yes No Have you ever been charged with a crime, other that a traffic ticket? * Yes No If yes, please explain * I understand that Battle Axes policy is that all applicants for employment are judged on the basis of qualifications and ability without regard to age, gender, race, religion, color, sexual orientation, national origin, marital status or disability. I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, false statements on this application shall be grounds for immediate dismissal. I investigation of all statements contained herein and the references listed to give Battle Axes any and all information concerning my previous employment and any pertinent information former employers may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same the Battle Axes. I understand and agree that, if hired, my employment is at will and may be terminated by Battle Axes at any time without any prior notice. I understand that I may be subject to random drug tests and may not use any drugs or alcohol while on Battle Axes premises. I acknowledge Battle Axes notification to me as required by the Fair Credit Reporting Act of 1970 that an investigative consumer report may be made regarding me, including information on my character, general reputation, personal characteristics and mode of living. Battle Axes is hereby authorized to fully investigate my criminal history, work records and qualifications either before or after my employment. Should I have a criminal conviction or a pending charge involving a breach of trust or dishonest act, I understand that Battle Axes may, in it's discretion, suspend or terminate my employment. I understand my employment with the Company is conditioned upon verification that I am a US citizen or alien authorization to work in compliance with the Immigration Reform and Control Act of 1986, as it may be amended from time to time, and regulations promulgated thereunder. By electronically signing below, you declare all information is true and not altered in any way. Applicant's Signature * Date * Submit If you are human, leave this field blank.
