Employment Application

Position Applying for: General

First Name*

Last Name*

Address 1*

Address 2

City*

State*

Zip Code*

Phone Number
(ex: 555-555-5555x5555)*

Alt Phone Number
(ex: 555-555-5555x5555)

Are you 18 years of age or older?*

YesNo

Are you legally eligible for employment in the United States?*

YesNo

Have you ever been convicted of a felony?*

YesNo

If Yes, please give all facts regarding conviction, including date, place and nature of conviction. Please note that a criminal conviction will not automatically disqualify you from a position with Southeastern Mills, Inc.

Can you perform the essential function of the job for which you are applying, with or without a reasonable accommodation?*

YesNo

If No, please describe accommodations:

What shifts can you work: *
AllFirstSecondThird

Date available for work*

Do you have any friends or relatives employed here?
Please list who and your relationship to them

* indicates required field