Employment Application Step 1 of 3 33% Date of Application MM slash DD slash YYYY Position Applied For* Email* Name* First Middle Initial Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime PhoneEvening PhoneName of Employee Who Referred You Employment HistoryList employment history beginning with your current positionEmployer Job Title Employer Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor Employment Start Date MM slash DD slash YYYY Employment End DateIf still employed, leave blank MM slash DD slash YYYY Duties Performed Reason for SeparationIf still employed, write “still employed” Employer Job Title Employer Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor Employment Start Date MM slash DD slash YYYY Employment End Date MM slash DD slash YYYY Duties Performed Reason for Separation EducationList educational accomplishments from most recent through high school. Include name and address of all schools, course of study, length of study, and diploma or degree earned. Include any specialized or technical training.Professional, Business and Civic Affiliations and CertificationsList professional, trade, business or civic activities and offices held currently or within the past ten years. Include professional certifications earned. Additional InformationAre you available for work on a full time basis? Yes No Are you available to work weekends? Yes No Have you ever been convicted of a felony? Yes No If yes, please explain. Conviction will not necessarily disqualify an applicant from employment. Are you prevented from becoming lawfully employed in this country because of Visa or immigration status? Yes No May we contact your present or previous employer? Yes No Are you or have you been employed by another Hershey entity (i.e., Milton Hershey School, Hershey Trust Company, The Hershey Company, or Hershey Entertainment & Resorts)? Yes No If yes, please name entity and dates employed. Additional InformationState any additional information you feel might be helpful to us in considering your application. ReferencesList references, including name, address and telephone number. Upload Your RésuméPdf files are preferred. You may also submit a word document.Accepted file types: doc, docx, pdf, Max. file size: 5 MB. Applicant’s Statement Important: Please read carefully before signing. I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of my employment, I understand that false or misleading information given in my application or interviews may result in discharge. I understand that in the event that I am hired, I will be hired as an at-will employee, and my employment may be terminated at any time, with or without cause, at the option of either the Foundation or myself. I understand that no representative of the Foundation except the Executive Director has any authority to enter into any legally binding employment agreement. A consumer credit report and/or criminal background check may be obtained at any time during the application process or during your employment with the employer. Upon written request to The M.S. Hershey Foundation, and within 5 days of the request, the name, address and phone number of the reporting agency will be disclosed to you. Before any adverse action is taken, based in whole or in part on the information contained in the report, you will be provided a copy of the report, the name, address and telephone number of the reporting agency, and a summary of your rights under the Fair Credit Reporting Act. I hereby expressly grant The M.S. Hershey Foundation the authority to obtain a consumer credit report and criminal background check in connection with my application for employment, and I agree to sign any further consents which might be required to complete these checks. I am providing the following information to be used solely for the purpose of obtaining the credit check and criminal background check, with the understanding that the information will not be used for any other purpose: Digital Signature*Typing your name in the box below verifies that you agree with the Applicant’s Statement above. Date of Digital Signature* MM slash DD slash YYYY