Palermo’s 95th Application for Employment


Personal Information

Employment Desired



Please Read Carefully Before Submitting the Application

The facts set forth in this application are true and complete. I understand that if employed, false statements on this application may result in immediate dismissal.
As part of the application review process, inquiries may be made regarding former employment, claimed education, driving records and credit of candidates for employment. Your completion of this application attests to the fact that you are aware that these inquiries will be made and that you authorize former employers and related agencies to discuss your employment and other records with a Palermo's representative.

I understand that this agreement supersedes any prior agreements or representations.
I also agree that I am aware that I may be subjected to a pre-employment drug screening and criminal history background investigation. Continued employment will be contingent upon favorable results.