CAREERS APPLICATION FOR EMPLOYMENT Step 1 of 8 - 1) Personal Information 12% M.A. Smoker Inc. is an equal opportunity employer. Employment decisions, including all hiring decisions, are made without regard to race, color, religion/creed, sex, national origin, ancestry, age, pregnancy, non-job-related disability, veteran status, possession of a General Education Development Certificate as compared to a high school diploma, or any other trait protected by applicable federal, state, or local laws. We strive to hire the hardest working and most qualified individuals.Please complete the entire application truthfully. Any falsifications or omissions may be grounds for immediate dismissal. If a given question is not applicable to you, you should answer N/A. An incomplete application will not be accepted.Personal InformationName* First Last Address* Street Address Address Line 2 City State ZIP Code Email* Home Phone #Cell Phone #* Personal InformationAre you at least 18 years of age?* Yes No If you are not at least 18 years of age, how old are you?*Are you legally eligible for employment in the United States?* Yes No Are you available to work full time?* Yes No Check the following you are willing work: Rotating shifts Overtime Saturdays Sundays Have you ever filed an application with us before?* Yes No If yes, give date* MM slash DD slash YYYY Have you ever been employed with us before?* Yes No If yes, give date* MM slash DD slash YYYY Personal InformationPosition(s) Applying For* Date You Can Start* MM slash DD slash YYYY Are you able to perform all of the essential functions of the job that you have applied for with or without a reasonable accommodation?* Yes No Have you ever been convicted of or pled guilty to, any felony or misdemeanor crime?* Yes No If you answered yes above, please list all crimes which you have been convicted of or pled guilty to and include the date of the offense. Please note that you will not automatically be excluded from consideration based upon a criminal record. Your suitability for the position sought will be evaluated based upon the circumstances in order to determine whether the criminal record renders you unsuitable for the job.*Have you been discharged or fired from any job that you have held within the past 10 years?* Yes No If you answered yes above, please describe the circumstances involved.*Please list the skills and/or qualifications which you feel would especially qualify you for the position for which you have applied.*Upload ResumeAccepted file types: pdf, docx, Max. file size: 512 MB. EducationChoose highest high school grade completed:* 7 8 9 10 11 12 G.E.D. Other High School Name* High School Address* Street Address Address Line 2 City State ZIP Code Choose years completed at college, trade, or business school:* None 1 2 3 4 5 or More College, Trade, or Business School Name* Major Studied at College, Trade, or Business School* College, Trade, or Business School Address* Street Address Address Line 2 City State ZIP Code List of Degrees, Diplomas, Licenses, and Certificates Current EmploymentAre you currently employed?* Yes No If no, how long have you been unemployed?* May we contact your present employer?* Yes No Current rate of pay Employer’s Name and Address*Employer’s Phone #*Immediate supervisor:* Description of current position and job duties*Has your employer taken any disciplinary action against you within the last two years?* Yes No If yes, explain the discipline and the reason in detail.* Previous EmployersPlease list your last four employers, starting with the most recent position. Do not skip any employers.1) Previous Employer’s Name, Address, Phone #Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Immediate supervisor:* Salary/Wage: Job Title:* Reason for Leaving:* Description of Job:* 2) Previous Employer’s Name, Address, Phone #Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Immediate supervisor:* Salary/Wage: Job Title:* Reason for Leaving:* Description of Job:* 3) Previous Employer's Name, Address, Phone #Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Immediate supervisor:* Salary/Wage: Job Title:* Reason for Leaving:* Description of Job:* 4) Previous Employer’s Name, Address, Phone #Date Employment Started*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date Employment Ended*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Immediate supervisor:* Salary/Wage: Job Title:* Reason for Leaving:* Description of Job:* Business ReferencesFirst & Last Name:* Company:* Company Street Address:* Phone:*Email:* Years Acquainted:* First & Last Name: Company: Company Street Address: Phone:Email: Years Acquainted: First & Last Name: Company: Company Address: Phone:Email: Years Acquainted: First & Last Name: Company: Company Address: Phone:Email: Years Acquainted: Personal ReferenceFirst & Last Name:* Address:* Phone:*Email:* Years Acquainted:* APPLICANT’S AUTHORIZATION AND CERTIFICATION PLEASE READ CAREFULLY I understand that providing false information on an application for employment is grounds for the Company to refuse to hire me, or to terminate my employment in the event that the misrepresentation is discovered after I have been hired. In submitting this application for employment, I authorize the Company to investigate all statements contained in it, and I understand that my current and/or previous employers may be contacted to provide information concerning my suitability for employment, and that the references whom I have listed above will be contacted concerning my suitability for employment. I expressly authorize the Company to conduct such inquiries and I release the Company and any responding parties from any and all liability associated with such inquiries. I understand that in the event that I am hired, I will be hired as an at-will employee, and my employment may be terminated at any time, without or without cause, at the option of either the company or myself. I understand that no representative of the company except Mark Smoker has any authority to enter into any legally binding employment agreement. I certify that I have read this entire employment application, including all information that I have provided on the application, and the entire statement set forth immediately above. I further certify that all of the information that I have provided on this employment application is true and correct. Date: ______________________ Signature: __________________________________________ (will be dated and signed upon first interview)PhoneThis field is for validation purposes and should be left unchanged.
