An Equal Opportunity Employer

Otownbooks LLC
Employment Application
An Equal Opportunity Employer

Otownbooks llc is an equal opportunity employer. This application will not be used for limiting
or excluding any applicant from consideration for employment on a basis prohibited by local,
state, or federal law. Applicants requiring reasonable accommodation in the application and/or
interview process should notify a representative of the organization.
(Instructions: Please fill out to the best of your abilities on the computer in Microsoft Word and
email it with your resume, if you have any questions use your best judgment)
Applicant Information
Applicant Name :
Phone:
Other :
Email Address :
Current Address:
Number and street :
City :
State & Zip :
DOB: (## MMM YYYY)
Employment Positions
Position applying for :
Are you applying for: (x)
Temporary work – such as summer or holiday work? [ ] Y or [ ] N
Regular part-time work? [ ] Y or [ ] N
Regular full-time work? [ ] Y or [ ] N
What days and hours are you available for work? (x each available grid)
Mor Noon Aftrnoon Evening Night Early Morning
Th
Sa
Sn
If applying for temporary work, when will you be available?

___________________________________________
If hired, on what date can you start working? (## MMM YYYY all dates must be in this format)
Are you available to work overtime? [ ] Y or [ ] N
Salary desired: $
Personal Information:
If hired, would you have transportation to/from work? [ ] Y or [ ] N
Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age.) [ ]
Y or [ ] N
If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal
right to work in the United States? [ ] Y or [ ] N
If hired, are you willing to submit to and pass a controlled substance test? [ ] Y or [ ] N
Are you able to perform the essential functions of the job for which you are applying, either with
/ without reasonable accommodation? (lifting in excess of 75 lbs) [ ] Y or [ ] N
If no, describe the functions that cannot be performed:
Do you have a concealed carry permit for Florida? [ ] Y or [ ] N
Are you proficient in the use of general firearms? [ ] Y or [ ] N

What type of car or truck do you drive?
Who is your auto insurer?
How many tickets (3 points or more) have you had in the past 5 years?
Do you own a laptop / computer?
My primary goal is to achieve:
Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ] N
If yes, please describe the crime - state nature of the crime(s), when and where convicted and
disposition of the case.
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal
offense. The date of the offense, the nature of the offense, including any significant details that
affect the description of the event, and the surrounding circumstances and the relevance of the
offense to the position(s) applied for may, however, be considered.)
Education, Training and Experience
High School:
School name: ________________________
School address:________________________
School city, state, zip:________________________________
Number of years completed:

Did you graduate? [ ] Y or [ ] N
Degree / diploma earned:
College / University:
School name:
School address:
School city, state, zip:

Degree / diploma earned:
Vocational School:
Name:
Address:
City, state, zip:
Degree / diploma? :
Military:
Branch:
Rank in Military:
Total Years of Service:
MOS:
Related details:
Additional Information
Do you speak, write or understand any foreign languages? [ ] Y or [ ] N
If yes, describe which languages(s) and how fluent of a speaker you consider yourself to be.
____________________
Do you have any other experience, training, qualifications, or skills which you feel should be
brought to our attention, in the case that they make you especially suited for working with us?
[ ] Y or [ ] N
If yes, please explain
Employment History
Are you currently employed? [ ] Y or [ ] N
If you are currently employed, may we contact your current employer? [ ] Y or [ ] N
Below, please describe past and present employment positions, dating back five years. Please
account for all periods of unemployment. Even if you have attached a resume, this section
must be completed.
Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):

Position & Duties:
Reason for Leaving:
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:

Position & Duties:
Reason for Leaving:
Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:

Position & Duties:
Reason for Leaving:
References
List below three persons who have knowledge of your work performance within the last four
years. Please include professional references only.
Name - First, Last:

Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:
Name - First, Last:

Telephone Number:
Address:
City, state, zip:
Occupation:
Name - First, Last:

Telephone Number:
Address:
City, state, zip:
Occupation:
Name - First, Last:

Telephone Number:
Address:
City, state, zip:
Occupation:
Name - First, Last:

Telephone Number:
Address:
City, state, zip:
Occupation:
Please Read and Initial Each Paragraph, then Sign Below (digitally)
I certify that I have not purposely withheld any information that might adversely affect my
chances for hiring. I attest to the fact that the answers given by me are true & correct to the best
of my knowledge and ability. I understand that any omission (including any misstatement) of
material fact on this application or on any document used to secure can be grounds for rejection
of application or, if I am employed by this company, terms for my immediate expulsion from the
company.
Initial:
I understand that if I am employed, my employment is not definite and can be terminated at any
time either with or without prior notice, and by either me or the company.
Initial:
I permit the company to examine my references, record of employment, education record, and
any other information I have provided. I authorize the references I have listed to disclose any
information related to my work record and my professional experiences with them, without
giving me prior notice of such disclosure. In addition, I release the company, my former
employers & all other persons, corporations, partnerships & associations from any & all claims,
demands or liabilities arising out of or in any way related to such examination or revelation.
Initial:
Applicant's Signature:
Date:
Best time and day for interview:
(save the file, and attach it to a return email to otownbooks2@gmail.com with a subject line
APPLICATION (your name))

An Equal Opportunity Employer

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An Equal Opportunity Employer

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Otownbooks LLC

An Equal Opportunity Employer

DOB: (## MMM YYYY)

Position applying for :

Are you applying for: (x)

Temporary work – such as summer or holiday work? [ ] Y or [ ] N

Regular part-time work? [ ] Y or [ ] N

Regular full-time work? [ ] Y or [ ] N

If applying for temporary work, when will you be available?

Are you available to work overtime? [ ] Y or [ ] N

If hired, would you have transportation to/from work? [ ] Y or [ ] N

If no, describe the functions that cannot be performed:

Do you have a concealed carry permit for Florida? [ ] Y or [ ] N

Are you proficient in the use of general firearms? [ ] Y or [ ] N

Who is your auto insurer?

Do you own a laptop / computer?

My primary goal is to achieve:

Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ] N

Education, Training and Experience

Number of years completed:

Number of years completed:

Do you speak, write or understand any foreign languages? [ ] Y or [ ] N

If yes, please explain

Are you currently employed? [ ] Y or [ ] N

If you are currently employed, may we contact your current employer? [ ] Y or [ ] N

Length of Employment (Include Dates):

Length of Employment (Include Dates):

Length of Employment (Include Dates):

Name - First, Last:

Name - First, Last:

Name - First, Last:

Name - First, Last:

Name - First, Last:

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