Poulin Design Center
Employment Application

(1) Most Recent Employer:

(2) Previous Employer:

(3) Previous Employer:

Resume:

Applicant Certification and Agreement

I certify that the facts set forth in this application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Company to make an investigation of any of the facts set forth in this application. I understand that the employer may give me a conditional job offer, following which I may be required to finish information regarding medical condition and history and any information regarding any pre-exsisting permanent physical impairment. I further understand that once given a conditional job offer, I will be required to submit to pre-employment testing for the illegal use of drugs.