Personal Information

Name






Address







Additional Information






Other

Is applicant over 18 years old: *
Is applicant eligible to work in US: *

Job Interests

Source Information






Previously Employed

Have you worked at XPAC before?: *



Preferred Schedule

Shift: *

Employment Type: *
Days Available for Work: *

Education

Education History











Fluent Languages

Speak Read Write
English:
Spanish:
French:
Burmese:
Karen:

Job Experience

Enter the number of years on the job experience for the following:



Professional References

Reference 1










Reference 2









Employment History

Employer 1













Employer 2













Employer 3













Employer 4












Other Information

Previous Convictions

Have you ever been convicted of a crime? (excluding misdemeanors and traffic offenses):

(A conviction will not necessarily disqualify an applicant from employment.)


Declaration

XPAC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws, except where age and sex are essential bona fide occupational requirements, or where disability is a bona fide occupational disqualification. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, transfer, leaves of absence, compensation, and training.

The above information is true and complete to the best of my knowledge. Any misrepresentation or false statement contained herein may be considered cause for possible dismissal. The Company has my permission to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment and personal history, and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice to me.

I understand this application does not constitute an employment contract of any kind. If hired, I may resign such employment at any time at my discretion with or without prior notice and the Company may terminate my employment at any time at their discretion, with or without cause and with or without prior notice.



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