SureGlow Stove & Chimney 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 accommodation in the application process, he or she should contact a company representative.

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Name

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Last

Address

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City

State

Zip Code

Phone

Date of Application

Employment Position

Position(s) applying for:

How did you hear about this position?

What days are you available for work?

If needed, are you available to work overtime?

On what date can you start working if you are hired?

Do you have reliable transportation to and from work?

Salary desired:

Personal Information

Have you ever applied to or worked for Ozark Stove And Chimney before?

If yes, when?

Do you have any friends, relatives, or acquaintances working for Ozark Stove And Chimney?

If yes, state name & relationship:

Are you 18 years of age or older?

Will you consent to a mandatory controlled substance test?

Are you a U.S. citizen or approved to work in the United States?

What document(s) can you provide as proof of citizenship or legal status?

Do you have any condition which would require job accommodations?

If yes, please describe accommodations required below.

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:

Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying:

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

Are you a member of the Armed Services?

What branch of the military did you enlist?

What was your military rank when discharged?

How many years did you serve in the military?

What military skills do you possess that would be an asset for this position?

Previous Employment

Employer Name

Job Title

Supervisor Name

Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone

Dates Employed

Reason for Leaving

References

crime(s), Name the

References

Name

Contact Info

Name (copy)

Contact Info (copy)

Name (copy) (copy)

Contact Info (copy)

Consent

AT-WILL EMPLOYMENT The relationship between you and the Ozark Stove And Chimney 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 Ozark Stove And Chimney. No representative of Ozark Stove And Chimney has 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.

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Date

Americans with Disabilities Act (ADA) Notice

At SureGlow Stove & Chimney, we are committed to ensuring that individuals with disabilities enjoy full access to our websites. In recognition of this commitment, we are in the process of making modifications to increase the accessibility and usability of this website, using the relevant portions of the Web Content Accessibility Guidelines 2.0 (WCAG 2.0) as our standard. Please be aware that our efforts are ongoing. If at any time you have difficulty using this website or with a particular web page or function on this site, please contact us by phone at (417) 582-7853; or email us at (info@sureglow.com) and place “Web Content Accessibility (ADA)” in the subject heading and we will make all reasonable efforts to assist you.

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