Careers

Associate Application Form

Associate Application
Equal Opportunity Employer | We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, citizenship, ancestry, genetic information, disability, military/veteran status, or any other legally protected status.
Position Applying For*
Specify Position*
How Did You Learn About Us?*
Please specify...*
Name*
First MI Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Secondary Phone Number
Email

Are under 18 years of age?*
Can you provide required proof of your eligibility to work?*
Have you ever filed an application with us before?*
Application Date*
Date Format: MM slash DD slash YYYY
Have you ever been employed with us before?*
Employment Date*
Date Format: MM slash DD slash YYYY
Are you currently employed?
May we contact your present employer?
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?
Proof of citizenship or immigration status will be required upon employment.
On what date would you be available to work?
Date Format: MM slash DD slash YYYY
Are you available to work:*
Are you currently on "lay-off" status and subject to recall?*
Can you travel if a job requires it?*
Have you been convicted of a felony?*
Conviction will not necessarily disqualify an applicant from employment. Factors such as date of offense, nature of offense, whether the conviction has been sealed and rehabilitation are considered.
Please explain...*

Education
Enter information of last grade completed.
Elementary School
Course of Study
Years Completed
Diploma/Degree
High School
Course of Study
Years Completed
Diploma/Degree
Undergraduate College
Course of Study
Years Completed
Diploma/Degree
Graduate/Professional
Course of Study
Years Completed
Diploma/Degree
Other (Specify)
Course of Study
Years Completed
Diploma/Degree
Indicate any foreign language you can speak
Indicate how fluent you are*
Indicate any foreign language you can read
Indicate how fluent you are*
Indicate any foreign language you can write
Indicate how fluent you are*
Briefly describe any specialized training, apprenticeship, skills and licenses held:
Briefly describe any job-related training received in the United States Military:

Employment Record
1st company
Company Name*
Position Title*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Date employed from:*
Date Format: MM slash DD slash YYYY
Date employed to:
Date Format: MM slash DD slash YYYY
Starting salary per week*
Ending salary per week*
Name and Title of Your Supervisor*
Briefly describe the work you did:*
Reason for Leaving*
Explanation*
- Add Another Experience
2nd Company
Company Name*
Position Title*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Date employed from:*
Date Format: MM slash DD slash YYYY
Date employed to:*
Date Format: MM slash DD slash YYYY
Starting salary per week*
Ending salary per week*
Name and Title of Your Supervisor*
Briefly describe the work you did:*
Reason for Leaving*
Explanation*
- Add Another Experience
3rd Company
Company Name*
Position Title*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Date employed from:*
Date Format: MM slash DD slash YYYY
Date employed to:*
Date Format: MM slash DD slash YYYY
Starting salary per week*
Ending salary per week*
Name and Title of Your Supervisor*
Briefly describe the work you did:*
Reason for Leaving*
Explanation*
Additional Information
Use this space for additional comments about your employment record

Personal References
1st Reference
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Occupation*
Years known*
- Add Another Reference
2nd Reference
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Occupation*
Years known*
- Add Another Reference
3rd Reference
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Occupation*
Years known*

Resume File Upload
Upload Your Resume
You are able to upload up to 3 files.
Drop files here or

Accepted file types: doc, docx, pdf.
Applicant Statement

I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS COMPLETE AND CORRECT. I UNDERSTAND THAT INCOMPLETE OR INCORRECT INFORMATION MAY BE GROUNDS FOR TERMINATION, IF I AM HIRED. I AUTHORIZE ALL SCHOOLS, FORMER EMPLOYERS, REFERENCES, COURTS, AND OTHER WHO HAVE INFORMATION ABOUT ME TO PROVIDE SUCH INFORMATION TO JIC. I RELEASE ALL PARTIES FROM ANY LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM PROVIDING SUCH INFORMATION. IF OFFERED A POSITION, I UNDERSTAND THAT I WILL BE REQUIRED TO SATISFACTORILY PASS A PRE-EMPLOYMENT PHYSICAL EXAMINATION AS A CONDITION OF EMPLOYMENT, I AGREE TO UNDERGO ANY MEDICAL EXAMINATIONS REQUIRED BY JIC. IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE RULES, REGULATIONS, POLICIES AND PROCEDURES OF JIC AND AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, FOR ANY REASON, AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT THE OPTION OF JIC OR ME. I UNDERSTAND THAT NO MANAGER, SUPERVISOR OR OTHER REPRESENTATIVE OF JIC OTHER THAN THE EXECUTIVE VICE PRESIDENT OF JIC HAS AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING AND THAT ANY SUCH EXCEPTIONS TO THIS EMPLOYMENT POLICY MUST BE MADE IN WRITING AND SIGNED BY THE PRESIDENT OF JIC. I UNDERSTAND THIS APPLICATION IS CONSIDERED CURRENT FOR THREE MONTHS. IF I WISH TO BE CONSIDERED FOR LATER EMPLOYMENT, I MUST RENEW AND UPDATE THIS APPLICATION IN WRITING.
ACKNOWLEDGEMENT*
- I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE STATEMENT
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Associate Application Form

Associate Application

Education

Employment Record

1st company

2nd Company

3rd Company

Additional Information

Personal References

1st Reference

2nd Reference

3rd Reference

Resume File Upload

Applicant Statement