Hiring Form

000-000-0000 or (000) 000-0000

Date

If needed, are you available to work overtime?

On what date can you start working if you are hired?

Do you have reliable transportation to and from work?
Have you ever applied to or worked for Twisted District before?
Do you have friends, relatives, or aquaintances working for Twisted District
Are you 18 years of age or older?
Are you a U.S. citizen or approved to work in the United States?
Will you consent to a mandatory controlled substance test?
Do you have any condition which would require job accommodations?
Have you ever been convicted of a criminal offense (felony or misdemeanor)?

If yes, please state the nature of the crime(s), when and where convicted and disposition of the case

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

High School

Did you graduate?

College/University

Enter the place of higher education you most recently attended, the year graduated (Or the anticipated date of graduation) and the degree and or credentials you received/are expected to receive

Vocational School/Specialized Training

Enter the place of higher education you most recently attended, the year graduated (Or the anticipated date of graduation) and the degree and or credentials you received/are expected to receive

Are you a member of the Armed Services?

LIST YOUR LAST THREE EMPLOYERS BELOW, STARTING WITH THE MOST RECENT. PLEASE INCLUDE THE DATE YOU STARTED, YOUR LAST DAY OF EMPLOYMENT, YOUR DUTIES, AND YOUR REASON FOR LEAVING.

Please include these in the boxes below: Start/End Month, Name and Address of Employer, Salary, Position, and Reason for Leaving

PLEASE PROVIDE AT LEAST ONE REFERENCE WHO IS NOT RELATED TO YOU, THAT YOU HAVE KNOWN FOR AT LEAST ONE YEAR

Please include these info in the boxes below: Name, Address, Business, Years known

AT-WILL EMPLOYMENT

The relationship between you and the Twisted District is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Twisted District. No representative of Twisted District has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President. I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

Do you certify that the above is true?

Signature date