Employment Application Full Name(Required) Last First M.I. Date(Required) Month Day Year Address PhoneAddress(Required) City State / Province / Region ZIP / Postal Code Email Date Available S.S. no Desired salaryPosition applied for Shift Preference(Required) 1st 2nd 3rd Shift Preference(Required) 1st 2nd 3rd Are you a U.S. citizen?(Required) Yes No If no, are you authorized to work in the U.S.?(Required) Yes No Have you ever worked for this company? Yes No If yes, when? Have you ever been convicted of a felony? Yes No If yes, explain? EducationCheck the highest grade completed in each school company below:High School 9 10 11 12 Tech School 1 2 3 4 College 1 2 3 4 Graduate School 1 2 3 4 High school Address From To Did you graduate?SelectYesNoDiploma College Address From To Did you graduate?SelectYesNoDegree Other Address From To Did you graduate?SelectYesNoDegree How did you hear about us? Chamber of Commerce Church Customer Referral Department of Labor Direct Recruit Employee Referral Friend / Relative Internet Website Job Fair – Where? Job Posting – Where? Newspaper – Which? Radio – Which station? School TV Ad Walk-in Yellow Pages Other ReferencesPlease list three professional references familiar with your work (Supervisors / Managers)Full name Title Company PhoneFull name Title Company PhoneFull name Title Company PhonePrevious EmploymentCompany PhoneAddress Supervisor Job title From To Responsibilities May we contact this employer? Yes No Company PhoneAddress Supervisor Job title From To Responsibilities May we contact this employer? Yes No Company PhoneAddress Supervisor Job title From To Responsibilities May we contact this employer? Yes No Military Service – did you serve in the United States military? Yes No Branch From To Rank at discharge Occupation 1. Have you ever applied for a position at Arrow? Yes No If yes, where and when did you apply? 2. Have you ever been employed with Arrow before? Yes No If yes, where and when did you work? 3. Are you prevented from lawfully becoming employed in this country because of VISA or Immigration status? Yes No 4. Are you currently legally authorized to work in the United States for any employer without restrictions and without requiring immigration sponsorship? Yes No N/A 5. Are you currently on layoff status and subject to recall? Yes No N/A 6. On what date will you be available for work? Month Day Year 7. Do you have a valid driver’s license? Yes No 8. Do you currently have any restrictions on your driver's license that would impair your ability to drive during the course of your employment? Yes No N/A 9. Do you have a commercial driver's license? Yes No N/A 10. Do you have reliable transportation Yes No 11. Do you possess a cell phone with call / text / data connection which does not depend on wi-fi? Yes No 12. Do you have any physical restrictions that may impact your work performance? Yes No 13. Are you able to lift at least 50 pounds of weigh? Yes No Disclaimer and signature I certify that the information on this application is correct, and I agree that this information may be verified by Arrow, its parent company or subsidiaries or affiliates to which I am applying, unless I have indicated otherwise. I also authorize you to check my references of past and present employers and personal history and agree to hold Arrow and all parties harmless and free from all liability for any damages from furnishing this information to Trillium in addition to the use or the disclosure of that information. I agree that any falsification, omission, or misrepresentation of the information on this application may result in my not receiving an offer of employment, or if I am hired, in the termination of my employment. If I accept employment from Arrow, I agree to follow all standards of employment established by Arrow. I understand that the employment relationship can be terminated at will, by either me or Arrow with or without cause, and without notice, at any time. I understand that all offers of employment are conditional upon proof of my identity and legal authority to work in the United States. READ CAREFULLY BEFORE SIGNING I agree that any action, claim or suit against Arrow, its parent company or subsidiaries, arising out of my employment or the termination of my employment, including but not limited to claims arising under State or Federal civil rights statutes, must be brought within 180 days of the event giving rise to the claims or they will forever be barred. I waive any limitation periods to the contrary.Applicant printed name Date Month Day Year Applicant signatureDate Month Day Year CAPTCHA
