Application for Employment

Street address or P.O. Box
Prior street address or P.O. Box
If previously employed by OSI, please provide dates- From: (Month/Year) To: (Month/Year)
If previously employed by OSI, please provide a brief reason for leaving.
Please provide month/date of last employment or N/A if no prior employment.
Check all that apply
Please tell us how you heard about OSI.
$ per hour
List all present and past employment, beginning with most recent
Current or most recent employer
Please provide a brief description of the reasons why you left or are planning to leave this position.
Previous employer
Please provide a brief description of the reasons why you left this position.
List people we may contact to discuss your history and qualifications for this position.
I certify that I have read and understood all of this employment application. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or not, and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical examination and drug test. I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason. I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal. If hired, I agree to abide by all the rules and policies of the employer. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Please type your first name as confirmation that you have read and understand the above information.