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Employment Application

Programs, services and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accomodation for the application or interview.

Application Data
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 Yes  No 
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 Yes  No 
If Yes, please explain:
Previous Employer:
Provide three professional references:
Provide three personal references:
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 Yes  No 
 Yes  No 
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"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter to any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release of use of disability related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws"

This application of employment is sold only for general use throughout United States. Adams assumes no responsibility and hereby disclaims any liability for the inclusion in this form of any questions or requestes for information upon which a violation of local, state, and/or federal law may be based. It is the user's responsibility to ensure that this form's user complies with applicable alws, which change from time to time.