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Other special training or skills (languages,
machine operation, etc.)
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Education
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Employment
Please give accurate,
complete, full-time employment and part-time
employment record. Start with your present or
most recent employer.
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| Military Service |
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Describe any training you received relevant
to the position for which you are applying.
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General Information |
How many days
of work have you missed in the last three years,
due to reasons other than paid holidays or vacation?
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If yes, please
give the date(s) and details.
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Signature
The information provided in
this Application for Employment is true, correct,
and complete. If employed, any misstatement
or omission of fact on this application may
result in my dismissal.
I understand that acceptance
of an offer of employment does not create a
contractual obligation upon the employer to
continue to employ me in the future.
If you decide to engage an investigative
consumer reporting agency to report on my credit
and personal history I authorize you to do so.
If a report is obtained you must provide, at
my request, the name of the agency so I may
obtain from them the nature and substance of
the information contained in the report.
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References
List persons who can discuss
your employment details and work-related characteristics.
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Applicant's Statement & Agreement
I understand that the company may investigate
my driving record and my criminal record and
that an investigative consumer report may be
prepared whereby information is obtained through
personal interviews with my neighbors, friends,
personal references, and others with whom I
am acquainted. This inquiry includes information
as to my character, general reputation, personal
characteristics, and mode of living. I understand
that I have the right to make a written inquiry
within a reasonable period of time to receive
additional detailed information about the nature
and scope of this investigation. I further understand
that the Company may contact my previous employers
and I authorize those employers to disclose
to the company all records and information pertinent
to my employment with them. In addition to authorizing
the release of any information regarding my
employment, I hereby fully waive any rights
or claims I have or may have against my former
employers, their agents, employees and representatives,
as well as other individuals who release information
to the Company, and release them from any and
all liability, claims or damages that my directly
or indirectly result from the use, disclosure,
or release of any such information by any person
or party, whether such information is favorable
or unfavorable to me. I authorize the persons
named here in as personal references to provide
the Company with any pertinent information they
may have regarding me.
I hereby state that all the
information that I provide on this application
or any other documents filled out in connection
with my employment, and in any interview is
true and correct. I have withheld nothing that
would, if disclosed, affect this application
unfavorably. I understand that if I am employed
and any such information is later found to be
false or incomplete in any respect, I may be
dismissed.
I understand and agree that,
if I am offered a position, it will be a conditional
offer based on my successfully passing a job
related medical examination which includes a
drug and alcohol screen. I understand and agree
that, if I accept a position, it will be on
the condition that my employment shall be "at
will" and for no definite period, and that
my employment may be terminated at any time
with or without cause or prior notice.
I hereby acknowledge that I
have had the opportunity to ask a Company representative
any questions regarding this application and
the above statements before signing and that
I have read the above statements and understand
them.
DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND
THE ABOVE STATEMENTS.
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