Personal Information

It is the policy of Love Inc. to extend equal employment opportunity to all applicants regardless of sex, race, color, marital status, physical or mental disabilities, religious belief or national origin.

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Are you 18 years of age or older?*

Yes
No

If under age 18, give birth date

If hired, can you provide proof that you are eligible to work in the U.S.?*

Yes
No

Have you ever applied here before?*

Yes
No

If so, when?

Have you ever been convicted of any criminal violation of law, or are you now under pending investigation or charges of criminal law?*

Yes
No

Please note: a criminal conviction is not an absolute bar to employment, but will be considered in relation to specific job requirements.

Emergency Information

Emergency Contact #1 Name*

First Last

Emergency Contact #1 Phone*

Emergency Contact #1 Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact #2 Name*

First Last

Emergency Contact #2 Phone

Emergency Contact #2 Address

Street Address Address Line 2 City State ZIP Code

Employment Information

Please list your job history for at least the last 3 jobs starting with your present or most recent employment.

Employer #1 Info

Name, Address & Phone # of Employer

Employment #1 Start Date*

Are you still at this job?*

Yes
No

Employment #1 End Date

Employer #2 Info

Name, Address & Phone # of Employer

Employment #2 Start Date*

Employment #2 End Date*

Employer #3 Info

Name, Address & Phone # of Employer

Employment #3 Start Date*

Employment #3 End Date*

References

List names and telephone numbers of three business/work references who are NOT related to you.

Reference #1 (name, address, phone, business)*

Reference #2 (name, address, phone, business)*

Reference #3 (name, address, phone, business)*

Education

High School (Name, City, State)*

Did you graduate?*

Yes
GED
No

College Info (name, year(s) attended, degree achieved)

File Upload

Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 2 MB.

Please read carefully before signing I certify that the answers given by me to the above questions and statements are true and correct and authorize you to contact references, past or present employers, persons, schools, law enforcement agencies and any other sources of information which may be relevant to my application for employment. It is understood and agreed that any misrepresentation, false statement, or omissions by me in this application will be sufficient reason for rejection of my application or for dismissal at any time during my employment, without liability to this company.

How Did You Hear About Us?

I have read, understand and agree to the above statement.*

Yes

If employed, I understand that I will be an employee "at will" and either the company or I may terminate my employment relationship at any time with or without notice for any reason not violative of the law.

I agree to comply with the company rules, regulations and policies, and acknowledge that these rules, regulations, and policies may be changed, interpreted, withdrawn, or supplemented at any time, and without prior notice to me.

I acknowledge that any offer of employment, or my acceptance of an employment offer, if such is to occur, may be withdrawn with or without cause, and with or without prior notice, at any time, at the option of the company. I understand that this application and any other documents which I may receive are not contracts of employment.

Digital Signature*