Employment Application

BR Supply, Inc. Welcomes You!

We are an Equal Opportunity Employer.

We consider applicants for all positions without regard to race, color, creed, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, and any other legally protected status. It is our policy to abide by all federal, state and local laws concerning discrimination in employment. No question in this application is intended to elicit information in violation of any such law nor will any information obtained in response to any question be used in violation of any such law. 

Personal Information

Education and Training

High School

College Or University

Trade School

Drivers License Information


List present and former employers.


List business persons known, but not related to you, other than listed above. 

Additional Employment Related Information

List any relatives or friends working for this organization:

NOTE: A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered. 

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge, and authorize BR Supply, Inc. to verify their accuracy and to obtain reference information on my work performance. I hereby release BR Supply, Inc. from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that my driver's license history and credit history may be reviewed. By signing, I authorize BR Supply, Inc. to verify my driver's license history and credit rating and history.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. 

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules, and regulations of employment of the BR Supply, Inc. However, I further understand that neither the policies, rules, regulations of employment, nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and that either I or BR Supply, Inc. may terminate my employment at any time with or without notice or cause.