Apply for Warehouse Associate

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Summary
Title:Warehouse Associate
ID:1005
Department:General Labor
Employment Status:Full Time
Location:Thomasville, NC
Shift Available:1st shift
Pay Rate:$13-$15/hr
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Contact Information
* First Name:
* Last Name:
* Date of Birth:
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* Address 1:
Address 2:
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Application Information
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Referred By:
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Cover Letter:
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Application Questions
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Application Questions

Are you currently employed?
Yes
No
May we contact this employeer?
Yes
No
* What shift(s) are you available to work?
1st shift
2nd shift
3rd shift
* What type of employment do you desire?
Full Time
Part Time
Long Term
Short Term
* What type of transportation do you have?
Own Vehicle
Friends Vehicle
Bus Line
Walk
* What areas are you willing to travel to?
High Point
Thomasville
Lexington
Greensboro
* Have you ever been convicted or pled guilty or no contest to any criminal offense other than a minor traffic violation?
Yes
No
* In case of an emergency the following people are allowed to pick up my paycheck.
* Do you have the legal right to remain and work permanently in the US?
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No

Emergency Contact

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References

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Education History

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* Employment History
Job Title, Company, City, Dates Worked

Release Authorization Form

By signing below, I authorize The Recruiting Specialist to verify any and all information given by me that
pertains to my eligibility for potential or continued employment. I fully understand that the information will
include, but is not limited to, criminal records, drug testing, credit history, employment verification, social
security number verification, motor vehicle driving record, education verification, and personal history. I
hereby give permission to employers, agencies, and personal references with whom I am acquainted to answer
all questions and release information being asked. Furthermore, I release any and all employers, bureaus,
agencies, individuals, data organizations, or companies named above from all liabilities of damages that might
occur from information obtained. I understand that the information regarding sex, race, and date of birth are
for the sole purpose of gathering the information correctly and will not be used to discriminate against me in
violation of an law. A facsimile (FAX) or photocopy of this release form shall be as valid as the original.

* Please list your name. First, Middle, and Last.
Please list any other name used in the last 7 years. (Maiden Name)
Please list any other cities or towns that you have lived in, in the past 7 years. (City, State)
* Please leave your signature.
* Please leave todays date.
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
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Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
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Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
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Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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