Job Application

Options, Inc. Job Application

Options is an equal employment opportunity employer and will not discriminate against any applicant or employee on any grounds protected under federal, state or local law, including race, color, creed, religion, age, sex, sexual harassment, national origin, ancestry, marital status, handicap, disability related to pregnancy or childbirth, affectional or sexual preference, membership or activity in any local commission, or status regarding public assistance, membership or non-membership in any labor organization, or any other characteristic protected under federal, state or local law. None of the questions in this application are intended to elicit information regarding protected characteristics, nor imply any limitation, preference or discrimination based upon protected characteristics.

If you are hired by Options, you will be employed on an at-will basis. As an at-will employee, you may terminate your employment at any time and for any reason. Similarly, if you are hired, Options will have the right to terminate your employment at any time and for any reason not prohibited by law.

Name:


Complete Address:


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Permanent Address, if different


,

Phone Number:

Alternate Phone Number:

Email Address:

Position you are applying for
Full TimePart Time

If hired, can you furnish proof that you are eligible to work in the United States?
YesNo
If No, explain:

Have you applied or worked for Options before?
YesNo
When?

Date you can start work:

Desired wage/salary:

Applicants for employment in certain positions may be required to drive Options's vehicles as an essential function of the position. Our insurance carrier requires that drivers of these vehicles have a "clean driving record". If you are not at least 21 and if you have 3 or more moving violations in the past 5 years, you will not be eligible for insurance coverage. Will you be eligible for insurance coverage and are you prepared to transport Options's consumers?
YesNo

Education

High School:
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College:
,

Trade:
, ,

Experience - give present or last position first

Employer Name:

Phone Number:

Address:


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Immediate supervisor:

Position:

Describe your duties:

Dates of employment:

Reason for leaving:

Experience Continued

Employer Name:

Phone Number:

Address:


,

Immediate supervisor:

Position:

Describe your duties:

Dates of employment:

Reason for leaving:

Experience Continued

Employer Name:

Phone Number:

Address:


,

Immediate supervisor:

Position:

Describe your duties:

Dates of employment:

Reason for leaving:

References:

1

2

3

Applicants for employment in certain positions are required to submit for post-offer medical examination to determine if they are able to perform the essential functions of the positions.
Are you prepared to do so?
YesNo

Are you available for work in the evening and weekends as may be required?
YesNo
If no, explain:

Do you plan to work for any other employer or engage in self-employment during your period of employment with options?
YesNo
If yes, explain:

Do you have any commitment or agreement with another employer that may affect your employment with Options?
YesNo
If yes, explain:

Are there any employer policies, requirements or terms or conditions of employment which you are unwilling to accept if you are offered employment?
YesNo
If yes, explain:

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