Leed Samples & Fulfillment is an Equal Opportunity Employer


Thank you for visiting our Online Employment Page which indicates that you may be interested in joining the Leed Team. Please take a few minutes to complete the following application and we will schedule a follow up interview providing your qualifications meet our needs.


Last Name:*
Are You Under the Age of 18?:*
Can You Provide a Work Permit?:*
Are You a Citizen of the United States?:*
Can You Provide a Valid Employment Authorization Document?:*


High School:*
Major Course of Study:
Years Completed:*
Major Course of College Study:
Years of College Completed:
Major Study:
Years of Other Schooling Completed:


Preferred Position (Check All That Apply):*
Other Preferred Position:
Preferred Shift:*
Schedule Preferred:*
Location Preference:*
Available Start Date:
Minimum Pay Desired:
Have You Previously Worked For Leed?:*
Start Date (Month/Year):*
End Date (Month/Year):*
Name if Different:
Do You Have Relatives or Close Friends Who Work For Us?:*


Have You Previously Worked for Other Employers?:*
Name of Current or Most Recent Employer:
City & State:
Start Date Employer 1 (Month/Year):*
End Date Employer 1 (Month/Year):*
Position at this Workplace:
Rate of Pay:
Frequency of Pay:
Reason for Leaving Employer 1:
May We Contact:
Name of Employer 2:
City & State of Employer 2:
Start Date Employer 2 (Month/Year):
End Date Employer 2 (Month/Year):
Position at Employer 2:
Rate of Pay for Employer 2:
Frequency of Pay for Employer 2:
Reason for Leaving Employer 2:
May We Contact Employer 2:
Name of Employer 3:
City & State of Employer 3:
Start Date Employer 3 (Month/Year):
End Date Employer 3 (Month/Year):
Position at Employer 3:
Rate of Pay for Employer 3:
Frequency of Pay for Employer 3:
Reason for Leaving Employer 3:
May We Contact Employer 3:

REFERENCES - We Would Prefer Work or Educational Related References

Name of Reference 1:
Phone Number of Reference 1:
Relationship to Reference 1:
Years You Have Known Reference 1:
Name of Reference 2:
Phone Number of Reference 2:
Relationship to Reference 2:
Years You Have Known Reference 2:
Name of Reference 3:
Phone Number of Reference 3:
Relationship to Reference 3:
Years You Have Known Reference 3:
Upload a Resume:
Any Other Information You'd Like to Share:
This Application of Employment is true and complete to the best of my knowledge and if it contains false or misleading information I may be disqualified for consideration for any position or if such false or misleading information leads to employment I may be discharged if subsequently discovered. If I am employed such employment relationship will be deemed as "at will employment" and my employment can be terminated at any time, with or without cause, at the will of the employer. As a condition of employment I will submit to a pre employment drug screen, which is paid by the employer.