Butler Fairman and Seufert Application of Employment
It is the policy of this company to provide equal employment opportunities to all qualified persons without regard to race, creed, color, religious belief,
sex, age, national origin, physical or mental handicap or veteran status.
Personal Information 
Current Address 
Street and Apt. #
Permanent Address (if different from above)
I have a current valid driver's liscense:         
I am an U.S. Citizen or otherwise authorized to work in the United States on an unrestricted basis: 
Have you ever been convicted of a crime in the past seven years (you are not obligated to disclose sealed or
expunged criminal records)?                        
Military Information 
Have you ever served in the U.S. Military?      
Show Date Picker   /    Show Date Picker    (ex. MM/DD/YYYY)