JOB APPLICATION

Q&A 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. Should an applicant need reasonable accomodation in the application process, he or she should contact a company representative

Please fill out all of the sections below:

Applicant Information





Employment Position



Personal Information

Yes No

Yes No

Yes No

Yes No


Yes No
Job Skills/Qualification
Note: Q&A complies with the ADA and considers reasonable accomodation measures that may be necessary for eligible applicants/employees to perform essential functions
Education and Training
High School
Name Location (City, State) Year Graduated Degree earned
college/University
Name Location (City, State) Year Graduated Degree earned
Vocational School/Specialized Training
Name Location (City, State) Year Graduated Degree earned

Military


Yes No





Previous Employment
Employer 1










Employer 2










Employer 3










References Please provide 3 personal or professional reference(s) below:
Reference Contact Phone
Additional Information
Any sales experience?
Yes No
Any problems walking or talking to strangers?
Yes No
Do you have a resume?
Yes No

Are there any other jobs that you have had in the past that you want to mention?

AT-WILL EMPLOYMENT
The relationship between you and Q&A is referred to as "employment at will". This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Q&A. No representative of Q&A has the authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will", and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.