PRE-EMPLOYMENT APPLICATION


Adams is an Equal Opportunity Employer and does not discriminate against employees or applicants for employment. All applicants will receive consideration based on their qualifications and without regard to race, color, religion, sex, national origin, age, disability or marital status. We comply with all applicable federal, state, and local laws.



Personal Information
Last Name:* First Name:*
Email:*
Address 1:*
Address 2:
City:* State/Province:*
Zip/Postal Code:*  
Phone: Home:*
  Work:
  Cell:
     
 
Interest At Adams
Position Applied For:
Part-Time
  Full-Time
Second Choice:
Part-Time
  Full-Time
How did you hear about us:
Your Availability:
Sunday: From: To:
Monday: From: To:
Tuesday: From: To:
Wednesday: From: To:
Thursday: From: To:
Friday: From: To:
Saturday: From: To:
 
Which Location(s):*
Deep River #586
Derby #585
Milford #425
Monson #498
Terryville #400
Watertown #582
White Hills #200
 
Experience
Please list your most recent jobs:
Company Name:*
Job Title:*
Start Date:*
(MM/DD/YR)
End Date*:
(MM/DD/YR)
Company Name:
Job Title:
Start Date:
(MM/DD/YR)
End Date:
(MM/DD/YR)
 
Education
High School: Year Graduated :
       
Degree: Major:
Institution: Year Graduated:
       
Degree: Major:
Institution: Year Graduated:
 
 
References
Name: Phone:  
Occupation: Years Known:  

Name: Phone:  
Occupation: Years Known:  

Name: Phone:
Occupation: Years Known:
 
Resumé (please paste your resumé in text format into this area):

APPLICANT'S STATEMENT

I understand that this application is not a contract of employment.
Federal laws require that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with such laws Adams will verify the status of every individual offered employment with the Company. Therefore, all offers of employment are subject to verification of the applicant's identify and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify your identification and employment authorization.

The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification for refusal of employment, or, if employed, termination from Adams.

Any offer of employment I may receive from Adams is contingent upon my successful completion of the Company's total pre-employment screening process, including the Company's receiving references which it considers satisfactory, and my satisfactory completion of any post-offer physical examination which the Company may require, which may include drug testing.

I authorize all previous employers, references or other persons having knowledge of myself or my record to release such information to Adams or its agents. I hereby release all persons who provide pertinent information in connection with the request for and release of such information from liability for any damage that may result from furnishing information to Adams.

In consideration of my employment, I agree to comply with all the policies, rules, regulations, and procedures of the Company. I further understand that no manager or representative of the Company, other than an Officer of the Company, has the authority to enter into any agreement for employment for the specified period of time or to make any agreement different from or contrary to the foregoing. I further understand that any such agreement, if made, shall not be enforceable unless it is in writing and signed by me and an Officer of Adams.

 
Signature:      Date: MM/DD/YR
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