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EMPLOYMENT APPLICATION


Access Sacramento Is An Equal Opportunity Employer
Please Complete and Sign This Application Form Even If Accompanied By Your Resume

PERSONAL INFORMATION
First Name
Middle Initial/Name
Last Name
per
Country
Address Line 1
Address Line 2
City
State
Postal Code
Country
Address Line 1
Address Line 2
City
State
Postal Code
Preference
Are you 18 years of age or older?

* If under 18, hire is subject to verification that you are of Minimum legal age.

If hired, can you present evidence of your U.S. Citizenship or proof of legal right to live and work in this country?
Have you ever filed an application or have been employed here before?
Do you have any friends or relatives working for our company?

EDUCATION RECORD
Years Completed
Years Completed
Years Completed
Years Completed

PAST EMPLOYMENT RECORD (Show Most Recent Employer First)
Country
Address Line 1
City
State
Postal Code

Dates of Employment:

(mo/yr)
(mo/yr)
May we contact?

Country
Address Line 1
City
State
Postal Code

Dates of Employment:

(mo/yr)
(mo/yr)
May we contact this employer for a reference?

Country
Address Line 1
City
State
Postal Code

Dates of Employment:

(mo/yr)
(mo/yr)
May we Contact?

ADDITIONAL SKILLS AND TRAINING

Please list additional skills and training that may be relevant on the position for which you are applying (i.e. computer skills, language, etc.):


EMPLOYMENT REFERENCES

Please list previous Managers or Supervisors whom we may contact for reference. If you do not have applicable previous employers, please list academic references.

First Name
Last Name

First Name
Last Name


Why do you feel you are qualified for this position? :

PLEASE READ CAREFULLY

I understand the company has, or may choose to implement, a program of appropriate Company-paid pre-employment physical examinations, including standardized drug screens. Offers of employment may be subject to the successful completion of such an examination, as well as verification of previous employment, education, and references. Any disparity between results of these efforts and the information contained in the application form may result in the withdrawal of such employment offer, or if work has begun, the termination of my employment.

I authorize the Company and its representatives to contact personal references, past Managers, educational institutions and credit reporting agencies, as it may deem necessary to obtain satisfactory information. I also authorize those contacted to release this information.

I certify that all of the information on this application was provided by me and is true. If employed, I agree to comply with all rules, regulations, and policies of the company. I understand and agree that my employment relationship with the Company is on an “at will” basis, meaning that either the company or I may terminate my employment at any time, for any lawful reason, with or without cause and with or without notice. I further understand and agree that if at any time during my employment any of the information herein is found to be misleading or untrue, my employment may be terminated.

I understand that, if employed, I will be required to furnish verification of my legal right to work in the Unites States by
providing acceptable documentation as required by statute within 72 hours of commencement of employment. Further, I
understand that in accordance with current Department of Homeland Security legislation, my employment will be terminated
at the end of that period should I not furnish the required documentation.

First Name
Last Name
Cover Letter and Resume Attachment

Click the browse button below to locate and select your cover letter and resume in digital format on your computer. Then attach it to this online application.

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