CA Docusign Intake Form

Home CA Docusign Intake Form
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Basic Information

Address(Required)

Relevant Employment Experience

Address(Required)
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May we contact?
Have you ever been involuntarily terminated or asked to resign from any job?

General Information

If hired, would you have a reliable means of transportation to and from work?
Can you travel if the position requires it?
Are you at least 18 years old?
Note: If under 18, hire is subject to verification that you are of minimum legal age
If hired, can you present evidence of your identity and legal right to work in this country?
Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?
Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions.

Applicant Statement and Agreement

Please read the statements below. On the next step you will be required to sign in agreement of each one.
  • If hired, I understand and agree that my employment in the Company is at-will, and that neither I, nor the Company is required to continue the employment relationship for any specified term. I further understand that the Company of I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.
  • I hereby authorize the Company to thoroughly investigate my record and other matters related to my suitability for employment and, further, authorize the prior employers I have listed to disclose to the Company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers, and all persons, corporations, partnerships, and associations from and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.
  • In the event of my employment with the Company, I understand that I am required to comply with all rules and regulations of the Company.
  • I understand that the safety of employees is extremely important to the Company and that the Company is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my supervisor and site manager in store locations. I under tand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.
  • I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery.
  • I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
  • I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed, and the remainder of this Agreement shall enforceable.

Documents Required on Next Step:

  • Driver's License
  • Social Security Card
Thank you for completing the required information, click the button below to generate your docusign forms and proceed to sign and upload your ID.