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VDSC Career Application Form

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CAREER APPLICATION

Van Diest Supply Company is an equal opportunity employer. Qualified applicants will receive consideration without regard to race, religion, color, creed, sex, sexual orientation, gender identity, age, national origin, marital status, disability or any other status protected by relevant state & federal laws.

General Information

First Name:

Middle Initial:

Last Name:

Email:

You will receive a confirmation email of this submission.

Address Line 1:

Street address

Address Line 2:

Apartment, suite, unit, building, floor, etc.

City:

State:

Zip:

Home Phone:

Cell Phone:

Social Security Number:

Date of Birth:

Have you filed an application here before?:

Have you ever been employed here before?:

Position(s) currently applying for:

Earnings Expected:

Per Year or Per Hour:

Referral Source:

Date available for work:

Are you available for full-time work?:

What hours are you available for work?:

Would you be interested in overtime work, if available?:

Are you authorized to lawfully work in the United States?:

If hired, a Form I-9, Employment Eligibility Verification form, must be completed at the start of employment.

Are you on lay-off and subject to recall?:

With or without reasonable accommodation, would you be able to perform the essential job function of the job for which you have applied?: