Employment Application

Various Federal, State and Local laws prohibit discrimination based on race, color, sex, religion, national origin, ancestry, age, disability or marital status. Triplett, Inc. is an equal opportunity employer and your response to any question will not be used as a basis for discrimination, but will be judged on its relevance to the position you are seeking. This application is active for one month after application date.

Required Form Fields Marked with *

Please ensure you fill out all required fields.

Yes     No

High School Information


College Information


Other Education Information


Military Service Information



Have you ever been convicted of a crime other than minor traffic violations? (Note: You are not obligated to discuss sealed or expunged records of conviction or arrest, nor will such information be asked of you or considered in employment decisions.) The existence of a criminal record will not automatically disqualify you from the job for which you are applying.


Answer the following question ONLY if you are applying for a Retail Store Position


Employment History

List employment starting with your most recent position.

Check this box if you've never been employed.   

Most Recent Employer

Check this box if this is your current employer.   

Second Most Recent Employer

Third Most Recent Employer

Fourth Most Recent Employer



Business References ONLY. Do not list relatives. (Please indicate if you were employed under a different name)

Required Form Fields Marked with *

Please ensure you have filled out all required fields.

Terms and Conditions

Please Read Carefully

Qualified applicants are considered without regard to race, color, religion, national origin, age, handicap or veteran status. I understand that this document is an application for employment, and does not constitute an agreement or contract for employment of any length of time. By accepting employment with Triplett, Inc. I understand that I have no expressed or implied contractual rights to continue employment with the company. I also understand that I am required to abide by all rules and regulations of Triplett, Inc., and all pertinent laws. I also understand that I have the right to terminate my employment at any time with or without reason and with or without notice. My employment with Triplett, Inc. is commonly referred to as Employment-at-Will.

I certify that answers given herein are true and complete to the best of my knowledge. I understand that with my authorization by signing below, an investigation may be made whereby information is obtained regarding my character, previous employment, general reputation, educational background, credit record, criminal record and /or motor vehicle record, subject to applicable federal, state and local laws. I authorize investigation of all statements in this application for employment as may be necessary in arriving at employment decisions. Triplett, Inc. has the right to contact, including but not limited to, previous employers, schools and other references to verify this information. I release from liability; including but not limited to, companies, individuals, parties and/or institutions supplying this information. In the event of employment, I understand that false, omissions or misleading information given in my application or interview or any required document may result in denial of employment or discharge, whenever discovered. After termination of my employment for whatever reason, I release Triplett, Inc. from liability for any information supplied to future potential employers.

Applicant's Signature

The entry of your name in the Applicant's Signature box binds you, the applicant, to the terms and conditions stated within this Employment Application.