Employment Application

First Name
Middle Name
Last Name
Address
Address Line 2
City
State/Province/Region
Zip Code
Email
Phone Number
Are you over 18?	YesNo
if no, provide DOB
Have you completed this form yourself?	YesNo
Do you hold a valid driving license?	YesNo
Are you authorized to work in the United States?	YesNo
Have you ever been convicted of a felony?	YesNo
if yes, please explain
Are you currently employed	YesNo
If so, please provide information about the employer
Name Company or Manager
Contact Number
Job Title
Annual Salary/Hourly Rate
Additional Benefits
Why are you considering leaving/have left?

Vacancy details

Postion(s) applied for?

Full TimePart Time Full Time positions are fully flexible and include working evenings, night and weekends.

If part time please specify what days and times are you able to work?

Emergency Contact Details

Contact Name
Relationship to you
Phone Number
Address

Education and Training

Please provide all qualifications from school through to college and university or any other relevant training courses.

Additional Qualifications & Licenses

Please detail any qualifications or memberships to professional organizations/bodies relevant to this position you have applied for e.g HEB, Walmart, etc.

Any additional comments

By clicking here you indicate your agree to the terms below.

Upon receipt of your application form, Shaddai Solutions, LLC will be the Data Controller of your personal data. Shaddai Solutions, LLC will hold all the information you have given on this application form for legal requirements and for the purposes of personnel administration and statistical analysis. Your information will be held on a manual file and will also be entered in its current or altered format onto the company's computarized database. No information may be passed onto a third party.

EEO:EEO-1 Voluntary Self Identification Form

The Equal Employment Opportunity Commission(EEOC) requires organizations with 100 or more employees to complete EEO - 1 report each year. Completion of data is voluntary and will not affect your opportunity for employment or terms or conditions of employment. This form will be used for EEO - 1 reporting purposes only and will be kept separate form all other personnel records only accessed by Human Ressources Department. This form will be sent to the Human Resources Department.

Name
Job Title
Gender	MaleFemale
Race/Ethnicity	HispanicWhiteBlack or AfricanNative Hawaiian or Other PacificAsian(Not Hispanic,Latino)American India or Alaska NativeTwo or More RacesOther
Date Completed

Shaddai Solutions, LLC and any related entity is an equal opportunity employer that adheres to a policy of making employment decisions without regard to race, color, religion, age, gender, sexual orientation, national origin or ancestry, marital status, disability or veteran status. Nothing in this application implies or promises actually that the applicant is creating an employment control with Shaddai Solutions, LLC and any related entity. Employment will be “at will of both parties” and is terminable by either party at any time, with or without cause. No offer of employment has been made at this time of application. The employer has my authorization to verify any information given on the application. I understand that any false information may result in immediate termination at any time.

Yes, I agree with Terms and Conditions.