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Please answer all questions completely. Requirements for placement include physical examination. All appointments to positions are on an introductory basis and subject to satisfactory work. Company policy, federal and state law prohibit discrimination on the basis of race, color, religion, national origin, sex, age or handicap.

Last Name*
First Name*

For “Yes” and “No” questions, please circle one answer.
Are you over 18 years of age? *
If hired, can you provide proof of eligibility to work in the United States? *
If hired, would you have a reliable means of transportation to and from work? *
Can you meet the attendance requirements of this job? *
Have you ever worked for Classic Distributing before? *
How were you referred to our Company? *
Can you perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? (Classic Distributing complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to complete skill and/or
agility tests.) *
Have you been convicted of a felony within the past seven (7) years? Have you ever been convicted of a crime regardless of whether that conviction resulted in a sentence, suspended sentence, probation, or other resolution following a plea, verdict, or other finding of guilt? In responding to this question, do not include arrests that did not lead to conviction, convictions for any drug-related offense more than two years old, or any participation in or referral to a pre-trial or post-trial diversion program. An affirmative response to this question will not result in your automatic disqualification from employment. *
Position Applying For*
Second Choice
Date Available*
Salary Desired*
Type of Employment (Select all that apply)*
Shifts you can work (Select all that apply)
School or
Name and Address From(MM/YYYY) - To(MM/YYYY) Did you Graduate?
Degree or
* * to


Professional certificates or licenses held
Are you fluent in any foreign language?
Office or computer skills
Dates (From-To)
Highest Rank Held
Special Training
List below all present and past employers for the last ten (10) years, starting with your most recent employer. Leave the company name blank if there is no work history.

Company Name Employed Date from to
Supervisor’s Name
Reason for leaving
May we contact this employer?

List below three (3) people we may contact who have knowledge of your work performance (do not include relatives)
Years Known

Years Known

Years Known
Please read the following statements carefully and select the appropriate box.
I certify that all answers or statements I have made on this application or on my resume or other supplementary materials are true and correct without omissions. I acknowledge that any false statement or misrepresentation on this application or supplementary materials will be cause for refusal to hire or for immediate dismissal from employment at any time during the period of my employment. I authorize this company to contact any of my past employers, except as otherwise indicated, and/or schools and authorize my past employers and/or schools to furnish any information concerning my previous employment and/or education. I release this company and all persons and organizations from all claims and liabilities of any nature arising from such investigations or the supplying of information for such investigations. In making this application for employment I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry may include information on my character, general reputation, personal characteristics and mode of living.
I hereby waive my rights under California’s Investigative Consumer Reporting Agencies Act to receive a copy of any public records obtained by Classic Distributing as part of an Investigative Consumer Report.
I understand that if I am offered employment by Classic Distributing, I will be required, within three working days, to present documents of identification and authorization to work in the United States in compliance with the Immigration Reform Act of 1986 and as a condition of employment.
I understand that all applicants tentatively selected for a position with Classic Distributing may be required to submit to a urinalysis test for illegal drug use prior to actual employment. I further understand that any offer of employment by Classic Distributing is contingent upon receipt of acceptable test results.
I understand that my employment is for no definite period of time and may be terminated at any time by the company or by me, with or without cause. I have no objection to signing an employee agreement on confidential information and inventions, taking a physical/medical examination at any time at the option and expense of the company, or making an application for a fidelity bond or security clearance. I have read and understand the foregoing statements and accept the same as conditions of employment.
I acknowledge that no representative of Classic Distributing has been or is authorized to enter into any agreement or commitment with me which is in any way inconsistent with the prior paragraphs. I understand that the terms of this document may not be modified in any way except by a written agreement signed by me and the President of Classic Distributing, which expressly states the intention of the parties to modify the terms of this application. I further understand that this statement supercedes any prior oral or written understanding and bars any future oral understanding to the contrary.