National Vendor is an equal opportunity employer. All qualified applicants will
be considered without regard to race, color, creed, religion, gender (including
pregnancy, childbirth or related medical conditions), national origin, ancestry,
age, physical or mental disability, medical condition including genetic characteristics,
family-care status, veteran status, marital status or sexual orientation, or any
other consideration made unlawful by federal, state, or local laws. This also includes
a perception that anyone has any of those characteristics, or is associated with
a person who has or is perceived as having any of those characteristics. National
Vendor also makes reasonable accommodations for disabled employees. California is
an "at-will" employment state, meaning that any future employment will be on an
at-will basis and you or National Vendor can terminate the employment relationship
at any time.
APPLICATION FOR EMPLOYMENT
Education (Do not need to fill out if this information is on your resume)
Work Experience (Do not need to fill out if this information is on your resume)
Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.
References (Do not need to fill out if this information is on your resume)
Please list at least three individuals qualified to give an opinion of youor professional work ability and work experence. Two out of three should be previous supervisors.
Read the Following Carefully Before Signing
Note: It is the practice of National Vendor to maintain a safe, and efficient working
environment. As part of this practive, we conduct background investigations. In
addition, if hired, you must furnish proof of your authorization to work in the
United States as specified under applicable U.S. Immigration Laws. One of these
documents must be photo identification. If you are employed by National Vendor,
you understand and agree that your employment is on an "at will" basis and may be
terminated with or without cause, with or without notice at any time, at the option
of either National Vendor or yourself. You understand that as a condition of employment
all applicants will be asked to sign a confidentiality disclosure agreement. Failure
to sign or abide by such agreement(s) may result in dismissal.
Please insert your initials in the appropriate space below if you understand and
agree to the following:
certify that the answers I have given to the foreging questions and statements (including any information on my resume) are
true and correct, without mental reservation of any kind, and I authorize National
Vendor to verify them.
I obtain employment resulting from this application, I agree to comply with all
orders, rules, and regulations of National Vendor.
authorize National Vendor to conduct reference checks from my former employers and
authorize all educational institutions to give transcripts of my records and grades.
I release them and their organizations from all liability for any damage whatsoever
for issuing same.
hired, a copy of my most recent payroll check stub and evidence of my highest education
degree may be required prior to start date.
I obtain employment resulting from this application, I understand that any employment-related
dispute I may have against National Vendor will be subject to binding arbitration,
and I will be asked to sign an arbitration agreement as a condition of employment.
upon investigation, anything in this application is found to be untrue, I understand
that I will be subject to dismissal at any time during the period of my employment.
understand that, in connection with my application for employment or during my employment
if I am employed, National Vendor may obtain information bearing upon my general
reputation, personal characteristics or mode of living, including public reocrd
information, without using a consumer reporting agency to obtain it. "Public record"
includes records documenting a conviction, civil judicial action, tax lien, or outstanding
judgment against me.
I the right to receive a
copy of any public record that National Vendor may obtain about me.
By inserting your name
and date below and submitting this document, you are stating that you have read,
acknowledge, understand, and agree to the above.
AFFIRMATIVE ACTION RECORD KEEPING
Any information you provide on this page is purely voluntary; such information will
be kept confidential, refusal to provide this information will not subject you to
any adverse treatment, and any such information you provide will be used only in
accordance with federal and state law and application regulations. This page will
be detached and remain separate from your employment application.
Position Applied For:
Ethnic Category (check one)
(Not of Hispanic origin): All persons having origins in any of the original peoples
of Europe, North Africa, or the Middle East.
(Not of Hispanic origin): All persons having origins in any of the black racial
groups of Africa.
All persons of Mexican, Puerto Rican, Cuban, Central or
South American, or other Spanish culture or origin, regardless of race.
All persons having origins in any of the original peoples of the Far East, Southeast
Asia, or the Pacific Islands. This area includes, for example, China, Japan, Korea,
the Philippine Islands, and Somoa. Also, persons from the Indian subcontinent, including
peoples with national origins from Bangladesh, Bhutan, India, Nepal, Pakistan, Sukkim,
and Sri Lanka.
All persons having origins in any of the original peoples of North America.
Disabled/Diabled Veteran/Vietnam Veteran
Identify yourself, if appropriate, as an individual with a disablity, a disabled
veteran or a Vietnam era veteran to enable us to have accurate data under our Affirmative
1) Has a physical or mental impairrment which substantially limits one of more of
that person's major life activities, or 2) Has a record of such impairment, and
3) Is capable (qualified) of performing a particular job with or without a reasonable
accommodation to his/her disability.
1) A person entitled to disability compensation under laws administered by the Veterans
Administration for disability rated at 30% or more, or 2) A person whose discharge
or release from active duty was for a disability incurred or aggravated in the
line of duty, and 3) Is capable (qualified) of performing a particular job with
or without a reasonable accommodation to his/her disability.
1) A person who a) actively served for more than 180 days, any part of which occurred
between August 5, 1964 and May 7, 1975 and was released with other than dishonorable
discharge, or b) was released from such active duty for a service-connected disability,
and/or 2) A person who was discharged/released within 48 months prior to an alleged
violation of the Act and/or of the regulation issued there under on July 26, 1976.
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