Employment Application

Are you able at the time of employment to submit verification of your legal right to work in the U.S.? 
(Verification and completion of Form I-9 must be submitted no later than three business days after date of hire.): *
If under the age of 18, can you produce the necessary work certificate at the time of employment? *
Type of Employment Desired? *
Are you willing to work overtime? *
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Within the past ten (10) years, have you been convicted of a felony? (Do not include convictions that were sealed, eradicated, erased, or expunged; convictions that resulted in referral to a diversion program; or marijuana-related convictions that are more than two (2) years old.) *
NOTE:
  • Criminal convictions will not automatically disqualify an applicant from a particular job. Fredonia Place will consider the nature of the crime, its seriousness, whether the conviction(s) substantially relates to the position’s functions and qualifications, the frequency of convictions, the applicant’s age at the time of conviction, the time elapsed since the date of conviction or completion of jail sentence, the applicant’s entire work and educational history, and employment references and recommendations.
  • An ex-offender who is denied employment may, upon written request, receive a statement of the reason(s) for denial within 30 days of the applicant’s request for such information

RESUME UPLOAD


YOU MUST COMPLETE THE ENTIRE APPLICATION AND ALL THE REQUIRED FIELDS BEFORE WE CAN PROCESS YOUR APPLICATION.

 

 I UNDERSTAND THAT NEITHER THIS APPLICATION NOR ANY COMMUNICATION BY A MANAGEMENT REPRESENTATIVE IS INTENDED TO CREATE OR DOES CREATE A CONTRACT OF EMPLOYMENT, OFFER, OR PROMISE OF EMPLOYEMENT. I ACKNOWLEDGE THAT IF HIRED BY THE COMPANY, EMPLOYMENT IS ON AN AT WILL BASIS. THIS MEANS THE COMPANY IS FREE TO TERMINATE MY EMPLOYEMENT AT ANY TIME, WITH OR WITHOUT CAUSE OR ADVANCED NOTICE, IN ACCORDANCE WITH STATE LAW, AND ACCEPTANCE OF EMPLOYMENT IS NOT A CONTRACT OF EMPLOYEMENT FOR ANY SPECIFICED TIME. SIMILARLY, I AM FREE TO TERMINATE MY EMPLOYMENT WITH THE COMPANY AT ANY TIME FOR ANY REASON. THIS AT WILL PROVISION MAY BE MODIFIED OR WAIVED ONLY IN A WRITTEN AGREEMENT SIGNED BY AN AUTHORIZED REPRESENATIVE OF THE COMPANY AND ME. I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFIY ITS POLICY OF EMPLOYMENT AT WILL.

We are an equal opportunity employer. Applicants are considered for positions without regard to race, religion, sex, national origin, age, disability, or any other consideration made unlawful by applicable federal, state, and local laws. 

Are you able at the time of employment to submit verification of your legal right to work in the U.S.(Verification and completion of Form I-9 must be submitted no later than three business days after date of hire.)  *
If under the age of 18, can you produce the necessary work certificate at the time of employment?  *
Type of employment desired? *
Are you willing to work overtime? *
Have you ever applied at Fredonia Place before? *
Within the past ten (10) years, have you been convicted of a felony? (Do not include convictions that were sealed, eradicated, erased, or expunged; convictions that resulted in referral to a diversion program; or marijuana-related convictions that are more than two (2) years old.) *
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* Note

Criminal convictions will not automatically disqualify an applicant from a particular job. Fredonia Place will consider the nature of the crime, its seriousness, whether the conviction(s) substantially relates to the position’s functions and qualifications, the frequency of convictions, the applicant’s age at the time of conviction, the time elapsed since the date of conviction or completion of jail sentence, the applicant’s entire work and educational history, and employment references and recommendations.

An ex-offender who is denied employment may, upon written request, receive a statement of the reason(s) for denial within 30 days of the applicant’s request for such information.

 
Have you ever initiated an act of violence in the workplace? *

Education

Please tell us about your Education. *
 High SchoolCollegeOther
Education
Course of Study
Graduate?
# of Years Completed
Degree/Major

Work Experience

Start with your present or last place of employment. You may include any verifiable work performed on a volunteer basis, internships, or military service. 

Employer #1

May we Contact? *

Employer #2

May we Contact? *

Employer #3

May we Contact? *

References

Please list the names of additional work related references we may call. Individuals with no prior work experience may list school or volunteer related references. 

Please Provide Information for References:
 Reference #1Reference #2
Name
Position
Company
Work Relationship
Telephone Number

APPLICANT CERTIFICATION

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on processing a valid driver’s license and automobile liability insurance in an amount equal to the minimum required by the state I reside.

I understand that Fredonia Place is a drug-free workplace and has a drug-testing program consistent with applicable federal, state, and local law. Since Fredonia Place has a drug-testing program and if I am offered a conditional offer or employment, I understand that if a pre-employment (post-offer) drug test is positive, the employment offer may be withdrawn. I agree to work under the conditions required by Fredonia Place that are consistent with federal, state, and local law. I also understand that all employees, pursuant to Fredonia Place’s policy and federal, state, and local law may be subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or controlled drugs. If employed, I understand that the taking of drug tests is a condition of continual employment and I agree to undergo drug testing consistent with Fredonia Place’s policies and applicable federal, state, and local law.

If employed by Fredonia Place, I understand and agree that Fredonia Place, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property.

I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality, non-compete, and/or conflict of interest statement.

I certify that all the information on this application, my resume, or any supporting documents is complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal.

 

I UNDERSTAND THAT NEITHER THIS APPLICATION NOR ANY COMMUNICATION BY A MANAGEMENT REPRESENTATIVE IS INTENDED TO CREATE OR DOES CREATE A CONTRACT OF EMPLOYMENT, OFFER, OR PROMISE OF EMPLOYEMENT. I ACKNOWLEDGE THAT IF HIRED BY THE COMPANY, EMPLOYMENT IS ON AN AT WILL BASIS. THIS MEANS THE COMPANY IS FREE TO TERMINATE MY EMPLOYEMENT AT ANY TIME, WITH OR WITHOUT CAUSE OR ADVANCED NOTICE, IN ACCORDANCE WITH STATE LAW, AND ACCEPTANCE OF EMPLOYMENT IS NOT A CONTRACT OF EMPLOYEMENT FOR ANY SPECIFICED TIME. SIMILARLY, I AM FREE TO TERMINATE MY EMPLOYMENT WITH THE COMPANY AT ANY TIME FOR ANY REASON. THIS AT WILL PROVISION MAY BE MODIFIED OR WAIVED ONLY IN A WRITTEN AGREEMENT SIGNED BY AN AUTHORIZED REPRESENATIVE OF THE COMPANY AND ME. I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFIY ITS POLICY OF EMPLOYMENT AT WILL.

I authorize Fredonia Place or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking and to the extent permitted by federal, state, and local law. I agree to complete any requisite authorization forms for the background investigation. I authorize and consent to, without reservation any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to Fredonia Place or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes or action, which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability Fredonia Place and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. 

I understand Fredonia Place hires only individuals who are legally eligible to work in the United States. 

Applicant Signature: *
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If the applicant is a minor, the foregoing release and consent must be signed by the applicant’s parent or legal guardian. Signature by the applicant’s parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that Fredonia Place, to the extent permitted by federal, state, and local law, can test the applicant for controlled substances, conduct inspections of property without notice, and communicate screen results to Fredonia Place personnel who need to know, the applicant, and the applicant’s legal guardian. 

Parent/Legal Guardian Signature:
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