Please fill out all fields.

Equal access to programs, services, and employment is available to all persons. Those applicants requiring a reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.

Position(s) applying for

Date of Application

Name (Last, First, Middle)

Address

City

State

Zip

Phone/Cell

Email Address

Have you ever been employed by Mavericks before?
YesNo

If yes, give dates and positions/Dates

Are you legally eligible for employment in this country?
YesNo

Date available for work

Desired pay range

Type of employment desired
Full-timePart-timeTemp

Shift
DaysNights

Are you able to meet the attendance requirements of the position?
YesNo

Have you ever plead "guilty" or "no contest" to, or been convicted of a crime?
YesNo

If yes, please provide date(s) and details

Answering "YES" to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Employment History
Provide the following information of your past four (4) employers, assignments, or volunteer activities, starting with the most recent.

Employment Dates

Job Title

Employer

Employer Phone

Address

City

State

Zip

May we contact for reference?
YesNoLater

Reason for leaving?

Hourly Rate
Start

Final

Employment Dates

Job Title

Employer

Employer Phone

Address

City

State

Zip

May we contact for reference?
YesNoLater

Reason for leaving?

Hourly Rate
Start

Final

Employment Dates

Job Title

Employer

Employer Phone

Address

City

State

Zip

May we contact for reference?
YesNoLater

Reason for leaving?

Hourly Rate
Start

Final

Employment Dates

Job Title

Employer

Employer Phone

Address

City

State

Zip

May we contact for reference?
YesNoLater

Reason for leaving?

Hourly Rate
Start

Final

Skills and Qualifications

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

Education Background (if job related)

High School

Location

Number of Years Completed

Did you graduate?
YesNo

College

Location

Number of Years Completed

Major

Degree

Course of study

Other

References

Name

Telephone

Number of years known

Name

Telephone

Number of years known

Name

Telephone

Number of years known

Applicant Statement
I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law.

I understand this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

if I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same 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 constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

DO NOT CHECK UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.