Allegany Door

Application for Employment: We appreciate your interest in working for Allegany Door and Hardware, Inc. As an equal employment opportunity employer, our employment practices are in accordance with the laws that prohibit discrimination due to race, sex, sexual orientation, age, disability, or national origin.

Applicant Information

Last Name (required)

First Name (required)

M.I.

Date (required)

Street Address (required)

Apartment/Unit #

City (required)

State (required)

Zip (required)

Phone (required)

E-mail Address (required)

Date Available (required)

Desired Salary

Position Applied for (required)

Date Available

Are you a citizen of the United States?
YesNo

If no, are you authorized to work in the U.S.?
YesNo

Have you ever worked for this company?
YesNo

If so, when?

Title

Have you ever been convicted of a felony? (Note: A conviction will not automatically disqualify you from employment).
YesNo

If yes, explain

SOURCE:

How did you find out about this job opportunity? Please check all that apply.

Company WebsiteWalk inNewspaperAgency ReferralJob BoardEmployee Referral

Name of referral source:

Education and Training

High School

Address

From:

To:

Did you graduate?
YesNo

College/University

Address

From:

To:

Did you graduate?
YesNo

Degree

Other

Address

From:

To:

Did you graduate?
YesNo

Degree

List professional certifications or designations, and date received.

References

Please list three professional references and colleagues

Reference 1

Full Name

Relationship

Company

Phone

Address

Reference 2

Full Name

Relationship

Company

Phone

Address

Reference 3

Full Name

Relationship

Company

Phone

Address

Employment History

This portion of the application must be completed even if a resume is submitted. Starting with the most recent employer, list full and part-time jobs, summer or volunteer working during the last 10 years. Include periods of military service, self-employment, and unemployment. Please leave no unexplained gaps. Attach a separate sheet if necessary.

Last or Present Employer

Last or Present Employer

Phone

Address

Supervisor's Name and Title

Job Title

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for Leaving

May we contact your previous supervisor for a reference?
YesNo

Previous Employer

Company

Phone

Address

Supervisor's Name and Title

Job Title

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for Leaving

May we contact your previous supervisor for a reference?
YesNo

Military Service

Branch

From:

To:

What type of education, training or work experience did you receive while in the military that will be relevant to the job you will be doing?

Status of Discharge

If other than honorable, explain

Disclaimer, Acknowledgement and Signature

I hereby authorize the Company, either on its own or by and through an agent, to thoroughly investigate my references, work record, education, and other matters related to my suitability for employment, such as criminal convictions, motor vehicle records, child protective service verification/sexual offender list and, further, authorize my present employer and any other party, including any Government or law enforcement agency and 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, except those which would indicate age, race, creed, color, sex, sexual orientation, or national origin. In addition, I hereby release the Company, my former employers, and all other persons, corporations, partnerships and associations from any claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

In consideration for employment, I agree to abide by all rules and regulations of the company; which may be changed, withdrawn, added or interpreted at any time, at the company's sole discretion and without prior notice to me. I understand that false statements or consequential omissions of any kind are sufficient grounds for denying employment or for dismissal. I hereby certify that the information hereunder is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

I understand that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to assure or make some other personnel move, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or to make any agreement, that is contrary to the foregoing. I hereby acknowledge that I have been advised that this application will remain active for no more than 90 days from the date it was signed. I understand this application will be kept in the company’s active files only until the position for which it was submitted is filled. I understand if I am not hired for the position, for which I have applied, I must complete a new application to be considered for future employment opportunities.

Employment at Will Statement

Employment with the Allegany Door And Hardware is voluntarily entered into, and you are free to resign from your position with the company at will, at any time, with or without cause.  Similarly, the Company may terminate the employment relationship at will at any time, with or without notice or cause. I agree to abide by the rules and regulations of the company. I acknowledge that my employment may be terminated, and any offer of employment, if such is made, may be withdrawn with or without prior notice, at any time, at the option of either the company or me.

Signature (required)

Date (required)

Print Name (required)