Employment Application
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.
Please read our privacy policy.

Position applied for: Date of application:
How did you hear about us? Advertisement Our website Internet Job Fair Friend Relative Other
Please explain:

Last Name: First Name: Middle Name:
Address: City: State: ZIP:
Telephone:Home: () - - Mobile: () - - SSN: - -
e-mail: Best time to contact you at home:

Date available for work:  Desired salary range: 
Type of employment: Full time Part time Seasonal

Yes NoAre you available to work overtime, if asked?
Yes NoIf required, can you work shifts?
Yes NoAre you at least 18 years of age and can provide proof of eligibility to work?
Yes NoHave you ever filed an application with Deep South before?
Please give date: 
Yes NoHave you ever been employed with Deep South before?
Please give dates:  -
Yes NoDo any of your relatives work with Deep South?
Please give name, relationship, location and department:

Yes NoIf a job offer is extended, do you agree to take a company-paid exam related to the essential requirements of the job if such an exam is required for all persons occupying the same or fundamentally similar jobs?
Yes NoWill you submit to a random screening test, if required, which detects the presence of drugs, alcohol, or other physically or mentally impairing substances?
Yes NoAre you physically and/or otherwise able to perform (with or without reasonable accommodations) the essential duties of the job for which you are applying?
Yes NoIs there any reason that you might have difficulty being bonded?
Yes NoIf the job for which you are applying involves driving, do you possess a valid driver's license issued by your state of residence?
Yes NoIf the job for which you are applying involves driving, have you been issued any citations for moving violations of any kind within the last three (3) years, "driving under the influence" or "reckless driving" at any time within the last five (5) years?
Please explain:
Yes NoHave you ever been convicted of a criminal offense other than a minor traffic violation?
Please explain:

EDUCATION
School Name & Address Course of Study Years Degree
High School
Undergraduate College
Junior/Community College
Graduate/Professional
Other/Vocational

WORK EXPERIENCE
Please list your work experience for the past seven years. Start with your present or last job, including any job-related military service assignments.
Employer:
 Date EmployedWork Performed:
FromTo
Address:
Hourly Rate/Salary
Telephone number(s):
 StartingFinal
Job title:
 Supervisor:
Reason for leaving:
 May we contact?
Yes No

Employer:
 Date EmployedWork Performed:
FromTo
Address:
Hourly Rate/Salary
Telephone number(s):
 StartingFinal
Job title:
 Supervisor:
Reason for leaving:
 May we contact?
Yes No

Employer:
 Date EmployedWork Performed:
FromTo
Address:
Hourly Rate/Salary
Telephone number(s):
 StartingFinal
Job title:
 Supervisor:
Reason for leaving:
 May we contact?
Yes No

Please account for all periods of unemployment of one month duration or longer over the past seven years. Please include volunteer work, temporary work, or special skills utilized during this time.
   From    To  Please explain what you were doing
mo. yr. mo. yr.
mo. yr. mo. yr.
mo. yr. mo. yr.

OTHER SKILLS, TRAINING, ACTIVITIES
Describe any other job-related information you think would be helpful to us in considering you for employment, such as specialized or military training, skills, extra-curricular school activities, special studies, publications, accomplishments, and additional work experience. You may exclude all information indicative of age, sex, race, religion, color, national origin or disability.
Other Qualifications: Summarize special job-related skills and qualifications acquired from employment or other experience.
Describe any job-related training received in the United States military:
List professional, trade, busisness or civic activities and offices held:

SPECIALIZED SKILLS
Please indicate by marking the appropriate boxes which skills you maintain:
Office Skills
Typewriter
Words per minute:
10-key Adding Machine
Sight Sound
Data entry
Other office skills
List additional skills below:
Computer Skills
IBM Lotus Notes
Internet Explorer
Microsoft Office
Microsoft Word
Microsoft Excel
Microsoft Access
Microsoft PowerPoint
Other computer skills
List additional skills below:
Language Skills
English
Spanish
French
German		 Chinese - mandarin
Chinese - cantonese
Vietnamese
Other
List additional languages:

REFERENCES
Give the name, address and phonenumber of three reference not related to you. Also indicate how long you have known the person.
Work-related reference preferred.
Name Address Phone number Years

For reference checking purposes, please indicate other names under which you have worked or attended school.
This could be for example maiden name, previously married name, nickname, etc.


RESUMÉ
Optional: upload your resumé. Please provide it in Microsoft Word format (.doc or.rtf), as plain text (.txt) or in Adobe Acrobat format (.pdf).



APPLICANT'S CERTIFICATE AND RELEASE
(Read Carefully Before Signing)

All information provided by me in support of my application for employment is true and correct to the best of my knowledge. I understand that misrepresentations or omissions will constitute sufficient grounds for rejection or for subsequent dismissal if I am hired.

I hereby authorize any current or former employer, school, person, firm, corporation, consumer or credit reporting agency, or government agency to answer any and all questions and to release or provide any information within their knowledge or records, and I agree to hold any or all of them blameless and free of any liability for releasing any truthful information that is within their knowledge or records, and I also agree to hold the Company blameless and free of any liability for using any Information received from such parties in making an employment decision regarding me.

The Company is hereby authorized to release to any other firm or person with whom I may seek employment, any and all information concerning my employment or application, including any information received from a third party as a result of an inquiry such as described in the foregoing paragraph, and I agree to hold the Company blameless and free of any liability for releasing any such information.

In the event of employment, I understand that I will be required to abide by all rules and regulations of the Company (including the signing of any required agreements dealing with inventions, confidential information, or any other terms or conditions of employment) which are now in effect or may be established in the future.

I further understand that in the event of employment, I will need to comply with the security procedures of the Company.

In compliance with the immigration law, I understand that if I am offered a job by the Company, my employment will be conditioned upon my timely production and completion of documents required to verify my eligibility for employment in the United States.

A photocopy of this signed Applicant's Certificate and Release shall have the same force and effect as an original.

I also understand that the issuance of this application does not indicate that there are any positions open and does not in any way obligate the Company.

I understand that any employment offer (or continued employment if employed) will be contingent upon my complying with all requirements outlined in this "Applicant's Certificate and Release" and any other employment- related requirements of the Company.

THIS EMPLOYMENT APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. SHOULD I BE OFFERED EMPLOYMENT OR BECOME EMPLOYED BY THE COMPANY, I UNDERSTAND THAT BOTH THE COMPANY AND I MAY END THE EMPLOYMENT RELATIONSHIP AT ANY TIME WITH OR WITHOUT CAUSE, WITH OR WITHOUT NOTICE AND WITHOUT LIABILITY TO ME FOR WAGES, SALARY, OR OTHER COMPENSATION EXCEPT SUCH AS I MAY HAVE EARNED THROUGH THE DATE OF SUCH TERMINATION. THIS PROVISION CANNOT BE CHANGED EXCEPT IN A WRITTEN EMPLOYMENT AGREEMENT SIGNED BY ME AND AN AUTHORIZED COMPANY REPRESENTATIVE.

I certify that I have carefully read the above and submit this application with full knowledge of these requirements.