APPLICATION FOR EMPLOYMENT

AMERICAN IS AN EQUAL OPPORTUNITY EMPLOYER
AND DOES NOT ENGAGE IN ILLEGAL DISCRIMINATION.

PERSONAL

02/04/2012

Name:

LAST

FIRST

MIDDLE INITIAL

Present Address:

NO. STREET

CITY

STATE ZIP

Telephone No.:

( )

E-mail Address:

AREA CODE

Job(s) applied for:

Rate of pay expected $ per

Do you want to work:

Full-time Part-time

Specify days and hours if part-time:

Have you worked with us before? Yes No

If yes, when?

List any friends or relatives working with us:

If hired, on what date will you be available to start work?

Are there any other experiences, skills, or qualifications which you feel would especially fit you for work with American?

EDUCATIONAL BACKGROUND

Have you ever been convicted of a crime, excluding minor traffic offenses and parking tickets? YES NO

If Yes, describe in full:

PRIOR WORK HISTORY

DATES		NAME AND ADDRESS OF EMPLOYER	RATE OF PAY		SUPERVISORS NAME AND TITLE	REASON FOR LEAVING
FROM	TO		START	FINISH
			$	$

Describe in detail the work that you did:

DATES		NAME AND ADDRESS OF EMPLOYER	RATE OF PAY		SUPERVISORS NAME AND TITLE	REASON FOR LEAVING
FROM	TO		START	FINISH
			$	$

Describe in detail the work that you did:

May we contact the employers listed above? YES NO

PERSONAL REFERENCES (Excluding Former Employers or Relatives)

NAME AND OCCUPATION	ADDRESS	PHONE NUMBER

If you have a resume and would like to send it along with this application, do so by clicking 'Browse'. Find your resume and click OK. Finally, click 'Update Attachments' to attach to this form. To remove an already attached document, click on the checkbox before the document name, then click 'Update Attachments'.

I hereby authorize American Solutions for Business to contact, obtain, and verify the accuracy of information contained in this application from previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either the employer or I may terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of American Solutions for Business not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that person's need for a reasonable accomodation as required by ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof in identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination if employment.

I represent and warrant that I have read and fully understand the foregooing, and that I seek employment under these conditions.

Please check here if you have read and understand the terms and conditions of this application.