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Mini Application

Applications for employment will not be accepted unless all required fields marked with an asterisk '*' are completed.

Personal Information
Full Name* Street Address* City*
State* Zip* Social Security Number*
Phone Number* Alternate / Mobile Phone Number Email Address*

Driver's License Number* State Issuing License*

Position and Salary Requirements
Position Applied for: * Date Available to Start * How did you hear of this opening?*
Hours per week* Expected Starting Wage*
Available: Nights Days Weekends

Employment History
Please list your most current employment.
Name of Company Phone Number Supervisor
Address City State
Type of Business Start Date End Date
Starting Wage Ending Wage Reason for Leaving
May we Contact
Yes No

Please list your most recently attended school.

Type of School
Name of School
Major Subject
Last Year Completed

If hired, do you have a reliable means of transportation to and from work?* Y N

Are you at least 18 years of age?* Y N
If you are under 18 years of age, can you provide proof of your eligibility to work? Y N

Only U.S. Citizens or Aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment provide documentation establishing your identity and eligibility to be legally employed in the U.S.?* Y N

Have you ever been convicted of a felony or first-degree misdemeanor? * Y N

Have you ever pled guilty or no contest to a crime that is a felony or first-degree misdemeanor? * Y N

NOTE: A "Yes" answer to the last two questions will not automatically bar you from employment. The nature, job-relatedness, severity, and date of the offense in relation to the position for which you are applying are considered.

Applicant's Certification & Agreement

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Five Star Development Group, LLC. to verify their accuracy and to obtain reference information on my work performance. I hereby release Five Star Development Group, LLC. from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that completion of this Application For Employment does not guarantee that I have been employed by this Company.

Five Star Development Group, LLC. is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.

** ** I herby accept the above agreement and certify the application is completed without any ommissions or falsified statements.

Please place your initials and type your name in the boxes below to serve as your digital signature of this employment application

Initials * Type your Name *

.: Hourly Employees :: Management Team :: Apply with Mini Application :.
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