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Yes No Prefer Not To Say Have you ever been convicted of a felony? Yes No Prefer Not To Say Are there any felony charges pending against you? Yes No Prefer Not To Say Please explain in detail. Note that a conviction does not mean you will not be offered a job.(Required)Desired EmploymentPosition Being Applied For(Required)Expected Pay Rate(Required)Per(Required)How did you hear of this position?(Required)Specify Preferred Employment Status(Required) Full Time Part Time Flexible / On Call Date You Can Start Work(Required) Specify Days / Hours You Can WorkFrom(Required)SundayMondayTuesdayWednesdayThursdayFridaySaturdayTo(Required)SundayMondayTuesdayWednesdayThursdayFridaySaturdayThis field is hidden when viewing the formHave You Worked or Applied With Us Before?(Required) Yes No If yes, when? Why Are You Interested In Working For MAX?(Required)Previous Employment HistoryNumber of JobsPlease enter a number from 0 to 3.Job 1Employer NameSupervisorEmployer AddressEmployment Start Date Employment End Date Starting Pay RateEnding Pay RateTitle / DutiesReason for LeavingJob 2Employer NameSupervisorEmployer AddressEmployment Start Date Employment End Date Starting Pay RateEnding Pay RateTitle / DutiesReason for LeavingJob 3Employer NameSupervisorEmployer AddressEmployment Start Date Employment End Date Starting Pay RateEnding Pay RateTitle / DutiesReason for LeavingReferencesName(Required)Affiliation(Required)Address(Required)Phone(Required)EducationPlease list your education information.Level (H.S., College, etc.)School NameCity/StateCourse of StudyGraduate? If yes, what year?Supplemental InformationPlease list all other training, certifications, skills, licenses, languages, internships, or other achievements that are applicable to the position for which you are applying. PLEASE NOTE IF YOU ARE BILINGUAL AND ABLE TO READ, WRITE AND SPEAK ENGLISH AND SPANISH.Emergency Contact InformationFull Name(Required)Relationship(Required)Phone Number(Required)Upload Application FilesMax. file size: 300 MB. Cover Letter and ResumeOptional InformationGenderMaleFemaleNonbinary/OtherEthnicityWhite (Not of Hispanic Origin)Black (Not of Hispanic Origin)HispanicAsian / Pacific IslanderAmerican Indian / Alaskan Native2 or More RacesAre you an individual with a disability? Yes No Prefer Not To Say Did you serve in the United States Armed Forces? Yes No Prefer Not To Say Consent APPLICANT’S CERTIFICATION AND AGREEMENT
