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Employment/Volunteer History 4

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Employment/Volunteer History 2

How were you referred for this position? *

Address *

Your Name: *

Employment/Volunteer History 5

Educational Background IF JOB RELATED

Have you ever been convicted of a misdemeanor* or served a period of incarceration for this conviction, within the last 5 years? *

Yes

If yes, please describe fully the criminal conviction(s), listing the nature of offense, the date of the offense and any period of imprisonment or probation:

Have you ever applied to Westfield before? *

Yes

Are you legally eligible for employment in this country? *

Yes

Are you able to meet the attendance requirements of this position? *

Yes

Position you are applying for *

Employment/Volunteer History 3

Skills and Qualifications

Please list 3 References and Phone Numbers we may contact: *

YOU MAY SKIP THE QUESTIONS BELOW IF YOU HAVE A RESUME TO UPLOAD. After uploading your resume, please sign the agreement below.

Have you ever been convicted of a felony? *

Yes

Accomplishments

Available to Start *

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I understand that if I am employed, any misrepresentation or material omission made by me on this application may result in cancellation of this application or immediate discharge from Westfield's service, whenever it is discovered. I give Westfield the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability Westfield and its representatives for seeking, gathering, and using such information and all other persons, corportions or organizations for furnishing such information. Westfield does not unlawfully discriminate in employment and no questions on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state or federal law. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and Westfield reserves the right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitue an agreement or contract for employment for any specified period or definite duration. I understand that no representative of Westfield, other than an authorized officer, has the authority to make any assurance to the contrary. I further understand that ay such assurances must be in writing and signed by an authorized officer. I understand it is Westfield's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA. I also understand that if I am hired I will be required to provide proof of identity and legal work authorization. I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions. I understand that by entering my electronic signature below, this is the legal equivalent of my manual signature on this Agreement. *

Are you under 18? *

Yes

Employment/Volunteer History 1

Phone *

Additional Information

Have you ever served in the Armed Forces? *

Yes

Employment/Volunteer History 6

If yes, please describe fully the criminal conviction(s), listing the nature of offense, the date of the offense and any period of imprisonment or probation:

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Call us at (508) 266-5495!