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Application for Employment

This organization is a drug-free workplace and an equal employment opportunity affirmative action employer.

Please fill out this application to the best of your ability and click "submit" at the bottom of this page.

All fields marked with an * are required for submission.

Note: We currently have job openings at our Orlando location for Sales Representatives and Office Staff.

* Last Name:	* First:	Middle:	* Social Security #:
Present Address:
* City:	* State:	* Zip:	* Phone:
Permanent Address:
City:	State:	Zip:	Phone:

Personal

* Position Applied for:	Desired Salary
How were you referred to us?	Are you applying for: full time part time seasonal / temporary
* Location: Millbury, MA Fort Myers, FL Orlando, FL

* Do you have the legal right to work in the united states? yes no if no, why?	Date available to begin work:

* Have you ever been employed here? yes no if yes, when?	* Are you younger than 18 years old? yes no If under 18, working papers or permit required.

* Have you been convicted of a felony in the past five years? yes no if yes, explain: NOTE: A yes response does not automatically disqualify an applicant for employment.	* Are you able to travel? yes no

Education:

	Course of Study	Last Year:	Graduate:	Diploma:
High School:
College:
University:
Other business college or special courses (including special training or post-graduate):
List Equipment Operated:

Previous Experience:

List name, address and phone number of previous employers in chronological order.

Title:

Employer:

Address:

Phone:

Duties:

From (date):

To (date):

Supervisor

Last Salary

Title:

Employer:

Address:

Phone:

Duties:

From

Supervisor

Last Salary

Title:

Employer:

Address:

Phone:

Duties:

From

Supervisor

Last Salary

Affiliations

Organizations in which you participate, or have participated, that you feel are relevant to your application. Consider school, business, professional or community affiliations.
School		Business or Community
Organization	Position Held	Organization	Position Held

Skills

Language Skills
Language	Speak: Fair Good Fluent	Read: Fair Good Fluent	Write: Fair Good Fluent

Language	Speak: Fair Good Fluent	Read: Fair Good Fluent	Write: Fair Good Fluent

Office Skills
Typing WPM: Shorthand Dictaphone Calculator 10-key Personal Computer Software: Excel Word Outlook Access Internet Explorer Other : Other skills and knowledge:

Military

Are you a U.S. Veteran?	yes no	Branch of Military:
Briefly describe duties and skills acquired through military service:

References

List at least three references that are not relatives:
Name	Title	Company	Phone

Statement

Please add any additional information you may think helpful to your consideration for employment:

Signature

READ THIS SECTION PRIOR TO PROVIDING SIGNATURE BELOW

I, the undersigned, agree that this organization may make any lawful inquiry that it considers necessary to determine my eligibility for employment. I authorize this organization to seek and obtain from my present and former employers, schools and personal references, information relating to my qualifications for employment. I release this organization and all persons and entities furnishing such information to this organization form any liability arising from dissemination or publication of such information.

I understand that any job offer with this organization is conditioned upon my ability to establish employment eligibility under the Immigration Reform and Control Act of 1986.

AGREEMENT FOR DRUG AND ALCOHOL TESTING. I freely and voluntarily agree to submit to a drug test as part of my application for employment. I understand that either refusal to submit to the test or failure to meet the standards established by this organization for this test may disqualify me for employment.

All information provided in this application and any accompanying resume is true and complete. I agree that any false or misleading representation or material omission may disqualify me from consideration for employment and may result in discharge, regardless of when discovered.

I have read and understand the foregoing and I agree unconditionally to the foregoing.

* I agree

* Date:
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One of New England's and Southwest Florida's leading stone importers, fabricators, and installers of natural and quartz surfaces, specializing in residential and commercial interior work for the wholesale industry.

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