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Application for Employment

All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking people dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring an accommodation to complete the application and/or interview process should contact human resources.

Position(s) applied for(Required)

Job Category

Location

(Enter Colorado, Utah, or Wyoming)

Hidden

Date of application(Required)

MM slash DD slash YYYY

Full Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Main phone number(Required)

Alternate phone number

Email(Required)

Employment Experience

Please list the names of your present or previous employers in chronological order with present or most recent employer listed first. Be sure to account for all periods of time. If self-employed, give firm name and supply business references. Add an additional page if necessary.

Employment Experience

Name of Employer	Actions

There are no Entries.

Maximum number of entries reached.

Have you ever been involuntarily terminated or asked to resign from any job?(Required)

Yes

Please explain

Please list any other experience, job-related skills, additional languages, or other qualifications that you believe should be considered in evaluating your qualifications for employment.

General Information

Have you ever worked for this company before?(Required)

Yes

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Do you have friends and/or relatives working for this company?(Required)

Yes

Name(s) and Relationship(s)

On what date are you available to begin work?(Required)

MM slash DD slash YYYY

If hired, would you have a reliable means of transportation to and from work?(Required)

Yes

Can you travel if the position requires it?(Required)

Yes

Can you relocate if the position requires it?(Required)

Yes

Are you at least 18 years old?(Required)

Yes

Note: If under 18, hire is subject to verification that you are of minimum legal age.

If hired, can you present evidence of your identity and legal right to work in this country?(Required)

Yes

Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?(Required)

Yes

We comply with the Americans with Disabilities Act and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions.

How did you hear about this job?(Required)

Who were you referred by?(Required)

Please tell us how you heard about the job(Required)

Applicant Statement and Agreement

Please read and accept each paragraph below. If there is anything that you do not understand, please ask.

I hereby authorize the company to thoroughly investigate my references, work record, and other matters related to my suitability for employment and, further, authorize the prior employers and 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. In addition, I hereby release the company, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.(Required)

In the event of my employment with the company, I understand that I am required to comply with all rules and regulations of the company.(Required)

If hired, I understand and agree that my employment with the company is at will and that neither I nor the company is required to continue the employment relationship for any specific term. I further APPLICATION FOR EMPLOYMENT | 4 understand that the company or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.(Required)

I understand that the safety of employees is extremely important to the company and that the company is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.(Required)

I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.(Required)

I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration law requires me to complete an I-9 Form in this regard.(Required)

I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed and the remainder of this Agreement shall be enforceable.(Required)

My signature attests to the fact that I have read, understand, and agree to all of the above terms.

Signature(Required)

Date(Required)

MM slash DD slash YYYY