Tompkinsville, KY 42167
800.489.6778

Employment

Employment Application

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Name
Address
Are you 18 years of age or older?
Have you ever worked for this company before?
Have you ever been convicted of a felony?

Education

GED
College:

Previous Employment 1

Address
May we contact your previous employer for a reference?

Previous Employment 2

Address
May we contact your previous employer for a reference? (copy)

Additional Information

References

Military Service

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. If hired, I agree to conform to the Company’s rules and regulations. I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the Company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the Company. 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 form upon hire. Any application that is not accompanied by a résumé will not be considered. For electronic submissions, résumés should be emailed to [email protected]. A typed name on the Signature line below is considered an Electronic Signature.
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Applicants have rights under labor laws.

EMPLOYEE POLYGRAPH PROTECTION ACT

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KNOW YOUR RIGHTS

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