APPLY NOWEmployee ApplicationPlease complete this form fully and accurately. TLC Diversified is an Equal Opportunity Employer and a Drug Free Workplace.Aplicar en Español: English English Español Please enable JavaScript in your browser to complete this form.1Applicant Info2Position Info3Education4Experience5Equal Employment InfoApplicant InformationName *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *ResumePlease upload your resume above.NextPosition Applied For *Background & Experience *Date available to start working: *Desired Salary / Hourly Wage *How did you hear about us? *SelectTLC EmployeeCraigslistRadioBillboardFacebookOtherOther (please specify): *Please indicate their name: *FirstLastAre you a citizen of the United States? *YesNoHave you ever been convicted of a felony? *YesNoAre you currently employed? *YesNoDo you have any obligations that would keep you from work-related travel? *YesNoIf yes, please explain why: *Have you ever worked for this company in the past? *YesNoPlease tell us what your reason for leaving and who your supervisor was: *PreviousNextEducationHigh SchoolAddress: City & StateDid you graduate?YesNoCollege NameAddress: City & StateDid you graduate?YesNoDegreePreviousNextPrevious EmploymentJob Title *Company *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStatePhone Number *Responsibilities *Starting Salary/Hourly Wage *Ending Salary/Hourly Wage *Date Started *Date Ended *Reason for leaving: *PreviousNextEqual Employment Opportunity InformationThis information is being requested in accordance with federal regulations. The information is voluntary and will not be used when considering you for employment with our company.EthnicityCaucasian / WhiteAfrican American / BlackAmerican Indian / AlaskanHI-Pacific Islander / AsianHispanic / LatinoTwo or more racesGenderMaleFemaleMilitary ServicePre-Vietnam EraVietnam EraPost-Vietnam EraDisabled VeteranDisclaimer & SignatureTLC Diversified complies with the Americans with Disabilities Act (ADA) of 1990. During the interview process, you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment, you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, all entering employees in the same job category will be subject to the same medical questionnaire and/or examination. All information will be kept confidential and in separate files. I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all matter containing in this application and hereby give the employer permission to contact, but not limited to, schools, previous employers, references listed, workers’ compensation, law enforcement agencies, departments of motor vehicles, and others as necessary and hereby release the employer for any liability as a result of such contact. I understand that misrepresentations and/or omissions of facts called for in this application will be cause for dismissal at any time without any previous notice. * *I agreeI understand and agree that all policies, procedures, whether written, published or orally communicated by the employer may be modified, amended, and/or deleted by the employer with or without notice to me. The employer’s policies and procedures are not intended to be a contract of employment nor do they give me a right of continued employment. If hired my employment may be terminated at my option or at the option of my employer with or without prior notice to either party. * *I agreeI understand that if hired, I will be placed on a 90 day orientation period. I further understand that if I am terminated for unsatisfactory work performance or attendance events within this period, it will be considered misconduct and the employer may seek to deny any unemployment benefits I might attempt to obtain as a result of my termination. * *I agreeTLC Diversified is a DRUG FREE WORKPLACE (DFW). If employment is offered it will be contingent upon the successful completion of a drug test. A copy of the DFW policy will be furnished to me once employment is offered. A confirmed negative drug test will result in that offer of employment continuing. A confirmed positive drug test will result in that offer of employment being withdrawn. It is a condition of continued employment that you must agree to future drug tests as per company policy and that any confirmed positive test result will be grounds for immediate termination. * *I agreeI understand that this application remains current for 90 days. At the conclusion of that time, if I have not heard from TLC Diversified and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. * *I agreeI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I also understand that my employment at TLC Diversified is at-will and may be terminated by either myself or TLC Diversified at any time for any reason or no reason at all, with or without cause or notice. * *I agreeToday's Date: *PreviousSubmit Please enable JavaScript in your browser to complete this form.Applicant InformationName *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *ResumePlease upload your resume above.NextPosition Applied For *Background & Experience *Date available to start working: *Desired Salary / Hourly Wage *How did you hear about us? *SelectTLC EmployeeCraigslistRadioBillboardFacebookOtherOther (please specify): *Please indicate their name: *FirstLastAre you a citizen of the United States? *YesNoHave you ever been convicted of a felony? *YesNoAre you currently employed? *YesNoDo you have any obligations that would keep you from work-related travel? *YesNoIf yes, please explain why: *Have you ever worked for this company in the past? *YesNoPlease tell us what your reason for leaving and who your supervisor was: *PreviousNextEducationHigh SchoolAddress: City & StateDid you graduate?YesNoCollege NameAddress: City & StateDid you graduate?YesNoDegreePreviousNextPrevious EmploymentJob Title *Company *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStatePhone Number *Responsibilities *Starting Salary/Hourly Wage *Ending Salary/Hourly Wage *Date Started *Date Ended *Reason for leaving: *PreviousNextEqual Employment Opportunity InformationThis information is being requested in accordance with federal regulations. The information is voluntary and will not be used when considering you for employment with our company.EthnicityCaucasian / WhiteAfrican American / BlackAmerican Indian / AlaskanHI-Pacific Islander / AsianHispanic / LatinoTwo or more racesGenderMaleFemaleMilitary ServicePre-Vietnam EraVietnam EraPost-Vietnam EraDisabled VeteranDisclaimer & SignatureTLC Diversified complies with the Americans with Disabilities Act (ADA) of 1990. During the interview process, you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment, you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, all entering employees in the same job category will be subject to the same medical questionnaire and/or examination. All information will be kept confidential and in separate files. I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all matter containing in this application and hereby give the employer permission to contact, but not limited to, schools, previous employers, references listed, workers’ compensation, law enforcement agencies, departments of motor vehicles, and others as necessary and hereby release the employer for any liability as a result of such contact. I understand that misrepresentations and/or omissions of facts called for in this application will be cause for dismissal at any time without any previous notice. * *I agreeI understand and agree that all policies, procedures, whether written, published or orally communicated by the employer may be modified, amended, and/or deleted by the employer with or without notice to me. The employer’s policies and procedures are not intended to be a contract of employment nor do they give me a right of continued employment. If hired my employment may be terminated at my option or at the option of my employer with or without prior notice to either party. * *I agreeI understand that if hired, I will be placed on a 90 day orientation period. I further understand that if I am terminated for unsatisfactory work performance or attendance events within this period, it will be considered misconduct and the employer may seek to deny any unemployment benefits I might attempt to obtain as a result of my termination. * *I agreeTLC Diversified is a DRUG FREE WORKPLACE (DFW). If employment is offered it will be contingent upon the successful completion of a drug test. A copy of the DFW policy will be furnished to me once employment is offered. A confirmed negative drug test will result in that offer of employment continuing. A confirmed positive drug test will result in that offer of employment being withdrawn. It is a condition of continued employment that you must agree to future drug tests as per company policy and that any confirmed positive test result will be grounds for immediate termination. * *I agreeI understand that this application remains current for 90 days. At the conclusion of that time, if I have not heard from TLC Diversified and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. * *I agreeI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I also understand that my employment at TLC Diversified is at-will and may be terminated by either myself or TLC Diversified at any time for any reason or no reason at all, with or without cause or notice. * *I agreeToday's Date: *PreviousSubmit
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