Employment Application

Welcome and thank you for your interest in Yachiyo.

To be considered for employment, you must complete this application IN ITS ENTIRETY. Resumes, though welcome, will NOT be accepted in place of a fully completed application.

Below are some requirements that you must meet to be considered for employment at Yachiyo. This list is not all-inclusive, and there may be additional requirements depending upon the specific job for which you are applying.

You must be at least 18 years old.
You must have reliable transportation, applicable insurance coverage, and a valid driver’s license for specific positions.
You must be a US citizen or a non-citizen legally authorized to work in the US for any US employer.
You may be required to take a test specific to a particular job.
Production, Maintenance, and Material Handling positions require the ability to stand or walk for 8 hours per day or more, and associates in those positions may regularly lift and/or move up to 10 pounds or more and occasionally lift and/or move up to, or even in excess of, 40 pounds as part of their essential job duties.
Meet other conditions as described in the application, operation standard(s), or job description(s).

All applicants will be considered for employment without regard to race, color, religion, sex (including pregnancy, childbirth, and related medical conditions), gender, sexual orientation, gender identity, national origin, citizenship, military/veteran status, age, disability, genetic information, or any other consideration made unlawful by applicable federal, state, or local laws.

"*" indicates required fields

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Applicant Information

Name*

First Middle Initial Last

Address*

Street Address Apartment/Unit # City State Zip Code

Phone*

Email*

Date Available*

Position Applied for*

Preferred Shift? Check all that apply:*

First Shift

Second Shift

Third Shift

Location of the position you are applying for*

Are you a U.S. citizen or otherwise authorized to work in the U.S. for any employer?*

Yes

Will you now or in the future require sponsorship for employment visa status?*

Yes

Have you ever worked for Yachiyo?*

Yes

If yes, when?*

Did someone refer you to Yachiyo?*

Yes

If yes, who?*

Are you at least 18 years old?*

Yes

Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation?*

Yes

List any foreign language fluencies:

Are there any days, times, or shifts that you are unable to work?*

Education

High School*

City, State*

Did you graduate?*

Yes

GED

College

City, State

Did you graduate?

Yes

Degree

Other Education, Specialized Training, or Certification

City, State

Did you graduate?

Yes

Degree

Previous Employment

If contract employment is in your history, please provide the contract/temporary agency information as well.

Company*

Supervisor*

Phone*

Address*

Job Title*

Responsibilities*

Dates of Employment*

Start Date - End Date

Reason for Leaving*

May we contact your previous employer?*

Yes

If no, explain:*

Add another previous employer?*

Yes

Company*

Supervisor*

Phone*

Address*

Job Title*

Responsibilities*

Dates of Employment*

Start Date - End Date

Reason for Leaving*

May we contact your previous employer?*

Yes

If no, explain:*

Add another previous employer?*

Yes

Company*

Supervisor*

Phone*

Address*

Job Title*

Responsibilities*

Dates of Employment*

Start Date - End Date

Reason for Leaving*

May we contact your previous employer?*

Yes

If no, explain:*

ACKNOWLEDGMENT AND AUTHORIZATION

Please read the following statements carefully:

I certify that the answers given by me on this application are true, correct, and complete, to the best of my knowledge. I understand that any misstatement, misrepresentation, or omission of facts on this application or any documents used to obtain employment may result in rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery of the misstatement or omission. I further certify that I, the applicant, have personally completed this application.
I authorize Yachiyo to investigate my references, prior employment, work record, education, and other matters related to my suitability for employment and, further, authorize the references that I have listed, all prior employers, and all educational institutions attended, to disclose to Yachiyo any information related to my employment records, including, but not limited to, my performance reviews and evaluations, discipline, commendations, awards, and all other employment information, without giving me prior notice of that disclosure. I understand and agree that they may express their opinions about me and my past or future performance. By providing this page of the application to the references, prior employers, and educational institutions attended, I release them, and their employees, managers, executives, board members, agents, or other representatives, to the fullest extent permitted by law, from any claims and liabilities for providing Yachiyo with all information, and I release Yachiyo and its employees, managers, executives, board members, agents or other representatives, to the fullest extent permitted by law, from any and all claims, and liabilities that may result from any use or disclosure of such information by Yachiyo or any of its employees, managers, executives, board members, agents, or other representatives. I agree to complete any required authorization forms for the background investigation.
I understand that any falsification, misrepresentation, or omission, whenever discovered, shall be considered legitimate and sufficient cause for dismissal.
I understand that any offer of employment is contingent upon my submission to and successfully passing a drug screen. I understand that if I test positive for drugs or refuse to consent to or cooperate with the drug test, the offer of employment may be withdrawn.
I understand that any offer of employment is contingent upon my submission to and successfully passing a background check. I agree to complete any required authorization forms for the background check.
I understand that any offer of employment is conditioned upon my ability to provide documents required by the Immigration Reform and Control Act of 1986, proving both my identity and authorization to work in the United States, and that my failure to produce the required documentation will result in revocation of the offer of employment, or termination of my employment.
I understand that I may be required to undertake a physical examination in connection with my application for employment. I hereby authorize any physician or clinic to release to Yachiyo the information derived from that examination as Yachiyo requires. I waive and release any claims that I might have against Yachiyo on account of the physical examination or the release of information from the physical examination to Yachiyo.
I am a bona fide applicant for employment with Yachiyo, and I am not making this application for employment with any fraudulent intent.
In consideration of my employment with Yachiyo, I agree to abide by all the Company’s rules and regulations.
I understand that nothing in this employment application creates a contract of employment between Yachiyo and me. If I am hired by Yachiyo, my employment will be “at will,” which means that my employment can be terminated at any time either by Yachiyo or me, with or without cause, and with or without notice. I understand that no manager or supervisor, other than Yachiyo’ s Executive Team, has the authority to make any employment agreement with me, either orally or in writing, for any specified period or that is contrary to the at-will nature of my employment. Any such agreement must be made in writing, duly signed by an authorized member of Yachiyo’ s Executive Team.
I understand that this application will be kept on active file for 60 days from the date completed, after which time I will have to re-apply if I want to be considered for employment after the 60-day expiration of this application.

By signing below, I certify that all the information I have provided on this application is true, accurate, and complete, and I have read, understand, and agree to the above statements. I also understand and agree that, by signing this application, I would be accepting employment, if hired, on the terms set forth in this application and that my acceptance of such employment would supersede, revoke, cancel, and negate any prior statements, agreements, practices, policies, and representations, oral or written, if any, that Yachiyo would employ me on any terms other than the terms set forth in this application.

Signature*

Date*

MM slash DD slash YYYY

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