Employment Application Lund's Fisheries IncApplicant InformationDate(Required) Today's DateFirst Name(Required) Last Name(Required) Middle Initial Street Address(Required) Apartment/Unit # City(Required) State(Required) State (abbreviation)ZIP Code(Required) Phone(Required) Email(Required) Date Available(Required) Desired Salary(Required) Position Applied For(Required) Position Type(Required) Full Time Part Time Select full time or part timeDue to the nature of our business, do you have any seafood allergies that we should be aware of? (Note: This is strictly for your protection and will not be held against you for employment opportunities)Seafood Allergies(Required) Yes No Do you have any seafood allergies that we should be aware of?List of Seafood Allergies If yes, to what are you allergic?Are you a citizen of the United States?(Required) Yes No If no, are you authorized to work in the U.S.? Yes No Are you under 18 years of age?(Required) Yes No If yes, can you furnish working papers? Yes No Can you travel if required by this position?(Required) Yes No Do you have any objection to working overtime?(Required) Yes No Are you able to meet the attendance requirements?(Required) Yes No EducationHigh School H.S. Address H.S. Attended From Date began attending High SchoolH.S. Attended To Date ended attending High SchoolDid you graduate High School? Yes No Diploma List any other skills or qualifications ReferencesPlease list three referencesReference 1 Full Name(Required) Reference 1 Relationship(Required) Reference 1 Years Known(Required) Reference 1 Phone(Required) Reference 2 Full Name(Required) Reference 2 Relationship(Required) Reference 2 Years Known(Required) Reference 2 Phone(Required) Reference 3 Full Name(Required) Reference 3 Relationship(Required) Reference 3 Years Known(Required) Reference 3 Phone(Required) Previous EmploymentCompany 1 Name Company 1 Phone Company 1 Address Company 1 Supervisor Company 1 Job Title Company 1 Responsibilities Company 1 Worked From Date began working at company 1Company 1 Worked To Date ended working at company 1Reason for leaving company 1 May we contact your previous supervisor at company 1 for a reference? Yes No Company 2 Name Company 2 Phone Company 2 Address Company 2 Supervisor Company 2 Job Title Company 2 Worked From Date began working at company 2Company 2 Worked To Date ended working at company 2Reason for leaving company 2 May we contact your previous supervisor at company 2 for a reference? Yes No Company 3 Company 3 Phone Company 3 Address Company 3 Supervisor Company 3 Job Title Company 3 Worked From Date began working at company 3Company 3 Worked To Date ended working at company 3Reason for leaving company 3 May we contact your previous supervisor at company 3 for a reference? Yes No Disclaimer and SignatureI certify that my answers are true and complete to the best of my knowledge. I hereby authorize Lund’s Fisheries, Inc. to contact, obtain, and verify the accuracy of information contained in this employment application from all previous employers, educational institutions and references. I also hereby release from liability Lund’s Fisheries, Inc. 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 grounds 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 my application does not constitute an agreement or contract of employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state laws. I also understand that while personnel policies, programs and procedures may, of necessity, change from time to time such at-will status is not subject to change without written agreement signed by the company’s president or designated authorized representative. I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual because of that persons need for a reasonable accommodation as required by ADA. I also understand that if I am employed, I am required to provide satisfactory proof of 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 of employment. I represent and warrant that I have read and fully understand the above mentioned and that I seek employment under these conditions.Digital Signature Agreement(Required) I agree By selecting "I agree" you agree that typing your name in the box below represents a digital version of your legal signatureApplicant Signature(Required) Date Signed(Required)
