937.550.9466
info@liberty-wear.com
Applicant Information
Date:
First Name
Last Name
M.I.
Phone #:
Email:
Street Address
SSN:
City
State
ZIP Code
Are you a U.S. Citizen?
If no, are you authorized to work in the U.S.?
Position Applied For:
Any friends or relatives that work for us?
Desired Salary:
Starting Date:
Ever been convicted of a felony?
If yes, explain:
Education
Highschool:
Address:
From
To
Graduate?
Diploma
College:
Address:
From:
To
Graduate?
Diploma
Address:
Other:
Diploma
To
From:
Graduate?
References
Please list 3 Professional references.
Relationship:
Phone:
Full name:
Company:
Address:
Phone:
Relationship:
Full Name:
Company:
Address:
Full name:
Phone:
Relationship:
Company:
Address:
Previous Employment
Company:
Address:
Phone:
Supervisor:
Job Title:
Starting Salary - Ending Salary:
From when to when?
Reason for Leaving?
Responsibilities:
May we contact your previous/current
supervisor for reference?
Company:
Address:
Job Title:
Supervisor:
Phone:
Starting Salary - Ending Salary:
From when to when?
Reason for Leaving?
Responsibilities:
May we contact your previous/current
supervisor for reference?
Company:
Address:
Job Title:
Phone:
Supervisor:
From when to when?
Starting Salary - Ending Salary:
Reason for Leaving?
Responsibilities:
May we contact your previous/current
supervisor for reference?
Organizations
Awards + Additional Information
Disclaimer And Signature?
I certify my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my
application or interview may result in my release. I understand that if I meet all requirements and characteristics as indicated in the job description, hiring may be
contingent upon successful completion of drug and alcohol test, a credit report, and medical examination. These costs will be borne by Liberty Wear Apparel, LLC.

I understand that if employed:
  • I may be required to work additional or fewer hours at other than my current assignment as the needs of Liberty Wear Apparel , LLC require.
  • My employment is subject to complying with those rules, regulations, and conditions as established by management.
  • I will be required to conform to all existing and future policies and procedures of Liberty Wear Apparel, LLC.
  • Liberty Wear Apparel, LLC reserves the right to change wages, hours, and working conditions, as deemed necessary.

I understand that if I am offered employment that I must provide appropriate documentation of my eligibility to work in the United States, in compliance with the
Immigration Reform and Control Act. I also understand that if I fail to provide the documentation required by law prior to my first day of employment, I will not be allowed
to begin work, and the offer of employment may be rescinded.

I understand that no employee is authorized to offer me employment, promise me salary increases, change of position, advancement, or any other advantages except
those officially announced by the owners of Liberty Wear Apparel, LLC.
Signature:
Date: