SPIN is an Equal Opportunity Employer that makes all employment-related decisions without regard to race, color, gender, religion, national origin, age, marital status or disability in accordance with federal law. In addition, SPIN complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities. SPIN also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans With Disabilities Act and applicable state and local non-discrimination laws.

In order that your application can be properly evaluated, it is essential that all of the questions be answered carefully and completely.

• Name First Middle Last
• Address (Current)
  Street Address City Postal / Code
• Address (Permanent) if different from current
  Street Address City Postal / Code
• Home Phone

  Cell Phone
• Email Address
• Is additional information regarding a name change, assumed name or nickname needed to check your work or school records?
  Yes No
  If Yes Please Specify:
• Have you previously interviewed for a position at SPIN?
  Yes No
  If You Answered Yes Above Please Specify:
  When:
  Where:
• Position Applying For:
  Desired Salary:
• What source referred you to SPIN?
  Employment Agency Newspaper Ad SPIN Employee SPIN's web site
  Other:
  Reffered By Employee:
• Do you have any relatives (parents, siblings, children, or spouse of any of them) who are current or former employees of SPIN?
  Yes No
  Relative's Name:
  Relationship:
• Are you legally employable in the United States?
  Proof of identity and employment eligibility will be required at the time employment commences.
  Yes No
• Do You Smoke?
  Yes No
• Do You Drive?
  Yes No
• Availability
  When Can You Start?
  Can You Work Overtime?
  Weekends?
• Have you ever committed, been charged with, or convicted of a felony (a "yes" answer will not necessarily disqualify you from employment)?
  Yes No
  If Yes Please Explain:
Personal
• High School
  Name:
  Location:
• Did You Graduate?
  Yes No
  Degree/Diploma:
  Date Received:
• College
  Name:
  Location:
• Did You Graduate?
  Yes No
  Degree/Diploma:
  Date Received:
• Post Graduate
  Name:
  Location:
• Did You Graduate?
  Yes No
  Degree/Diploma:
  Date Received:
• Other Training/Education
  Name:
  Location:
• Did You Graduate?
  Yes No
  Degree/Diploma:
  Date Received:
• If you have any foreign language skills, please specify:
• Do you have any other special skill or abilities that are relevant to the job you are seeking?
PROFESSIONAL EXPERIENCE
(Please list current/most recent employer fist, we will contact all previous employers, unless specifically stated not to)
• Employer 1
  Company Name:
  Position:
• Address
• Dates Employed:
  Supervisor:
• Telephone:
  Starting Salary:
  Ending Salar
  Reason for leaving:
• Once an offer is extended and accepted may we contact this employer?
  Yes No
  If not, why?
Employer 2
• Company Name:
  Position:
• Address
• Dates Employed:
  Supervisor:
• Telephone:
  Starting Salary:
  Ending Salar
  Reason for leaving:
• Once an offer is extended and accepted may we contact this employer?
  Yes No
  If not, why?
Employer 3
• Company Name:
  Position:
• Address
• Dates Employed:
  Supervisor:
• Telephone:
  Starting Salary:
  Ending Salar
  Reason for leaving:
• Once an offer is extended and accepted may we contact this employer?
  Yes No
  If not, why?
• Work availability:(Check all that apply)
  Full Time Part Time Temporary Days Evenings Weekends All
• List Hours and Days Available to work:
  Sunday
  Monday
  Tuesday
  Wednesday
  Thursday
  Friday
  Saturday
• References:
  Please list (4) professional references we may contact.
  Name:
  Telephone:
  Relationship:
  Name:
  Telephone:
  Relationship:
  Name:
  Telephone:
  Relationship:
  Name:
  Telephone:
  Relationship:

• I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission of information on this form or relating to my application of employment may result in denial of employment, or if employed, my immediate dismissal. I further understand that this application is not a contract, offer, or promise of employment.

  I understand and agree that my status is that of an employee at will, meaning I have no contractual right, express or implied, to remain in the employ of SPIN. In consideration of my employment, I agree to abide by the policies, procedures, and rules of SPIN as from time to time in effect, and that my employment and compensation can be terminated with or without notice, at any time, at the option of either SPIN or myself. I understand that no officer or representative of SPIN has the authority to enter into any agreement with me for employment for any specified period of time, or to make any agreement contrary to the foregoing.

  I agree to a background check, physical examination, if requested, and understand that failure to meet any medical and/or health requirements for the position may prevent my employment with the company (the aforementioned administered in accordance with state and federal laws). I also understand that employment, for certain positions, will be conditional upon successful completion of a substance abuse screening test as part of the company's pre-employment policy.

• Electronic Signature:
  Date: