Employment Application

Application For Employment

Pre-employment Questionnaire
Equal Opportunity Employer

Name & Location Of School

Years Attended *

Graduate? (Yes/No) *

Subjects Studied

Start/End Date *

Name & Address of Employer *

Wage *

Reason For Leaving *

Name *

Address *


Years Known

“Seekonk Supply is an equal opportunity employer. Seekonk Supply does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

“I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Seekonk Supply to hire me. If I am hired, I understand that either Seekonk Supply or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Seekonk Supply has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Seekonk Supply true and complete information on this application. No requested information has been concealed. I authorize Seekonk Supply to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of unemployment or immediate dismissal.