Job Application - Britton Lumber Company

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question
on this application is used for the purpose of limiting or excluding any applicant from consideration for
employment on a basis prohibited by local, state, or federal law. Equal access to employment, services,
and programs is available to all persons. Those applicants requiring reasonable accommodation to the
application and/or interview process should notify a representative of the organization.

First Name

Last Name

Email Address

Phone Number

Are you over the age of 18?

Address 1

Address 2

City

State

Zip Code

Date you will be available to start work

Have you ever been employed by Britton Lumber Company?

If Yes to above, when was your last year of employment?

How were you referred to us?

Driver License Number

(only required if driving for Britton Lumber is an essential job duty)

Employment History

Previous Employer 1

Supervisor

Hire Date

Job Summary

Position Held

Supervisor or Employer Phone Number

End Date

Reason For Leaving

Previous Employer 2

Supervisor

Hire Date

Job Summary

Position Held

Supervisor or Employer Phone Number

End Date

Reason For Leaving

Previous Employer 3

Supervisor

Hire Date

Job Summary

Position Held

Supervisor or Employer Phone Number

End Date

Reason For Leaving

Other Skills and Qualifications

Summarize any job-related training, skills, licenses, certificates, and/or other qualifications

Education History

High School

College

Technical School or Training

Technical School or Training 2

Other

Graduation Date

Completion Date

Completion Date 2

Completion Date

References

Name

professional reference preferred

Name

professional reference preferred

Name

professional reference preferred

Phone Number

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information
contained in this application from all previous employers, educational institutions, and references. I also
hereby release from liability the potential employer and its representatives for seeking, gathering, and
using such information to make employment decisions and all other persons or organizations for
providing such information.
I understand that any misrepresentation or material omission made by me on this application will be
sufficient cause for cancellation of this application or immediate termination of employment if I am
employed, whenever it may be discovered.
If I am employed, I acknowledge that there is no specified length of employment and that this application
does not constitute an agreement or contract for employment. Accordingly, either I or the employer can
terminate the relationship at will, with or without cause, at any time, so long as there is no violation of
applicable federal or state law.
I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate
against a qualified individual with a disability because of that persons need for a reasonable
accommodation as required by the ADA.
I also understand that if I am employed, I will be required to provide satisfactory proof of identity and
legal work authorization within three days of being hired. Failure to submit such proof within the
required time shall result in immediate termination of employment.
I represent and warrant that I have read and fully understand the foregoing, and that I seek employment
under these conditions.

By submitting this form, I understand and agree to the terms and conditions above.