Employment Application

Contact Information

Position Applying For:

Position desired

Full Time/Part Time Full TimePart Time

Salary Requirement

Applicant Eligibility

Are you 18 years of age or older? YesNo

If no, do you have a work permit? YesNoDoes Not Apply

Are you a US Citizen? YesNo

If no, what type of work permit do you have?

If hired, can you provide proof that you are eligible to work in the United States? YesNo

Have you ever been arrested? YesNo

Have you ever been convicted of a felony? YesNo

Have you ever been convicted of a misdemeanor? YesNo

If yes to any above, list all convictions, offenses, or pending charges.

Educational Background

High School

Year Started Year Ended Graduated? YesNo


Year Started Year Ended Graduated? YesNo

Work History

Employer 1

I am currently employed here YesNo

Start Date End Date

Employer 2

I am currently employed here YesNo

Start Date End Date


Date of Submission:

How did you hear about us?

Additional Notes

I understand that all of the above information is true and that falsification of any information on this application is grounds for termination. I also understand that I must be available for employment between the hours of 7:30am-5:30pm, Monday-Friday and Saturdays if needed.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for ACS Company to hire me. If I am hired, I understand that either ACS Company or I can terminate my employment at any time and for any reason, with or without cuase, and withour prior notice. I understand that no representative of ACS Company has the authority to make any assurance to the contrary. I authorize ACS Company to contact any references provided throughout my application process. If any information I have provided is untree, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Check this box if you agree