If at the above address for less than three years, list below all residences for the past three years.
If offered a position with us, would you be willing to take a drug/alcohol screening exam before and/or after employment as an employment condition?
If hired, can you furnish proof that you are eligible
to work in the U.S.?
Are you at lease 18 years old?
Describe prior experience related to this work:
Describe any formal schooling or training related to this work:
List any licenses, certificates, or professional affiliations you have:
List any special skills you may have (computer, machine operations, etc.):
Availability for Work
Will you work daily overtime on occasion if neccessary?
Are you now or do you expect to be engaged
in any other business, employment, or schooling?
Do you have any commitments or agreements
with another employer that might affect your
Do you have any on-going obligations or other
personal commitments that would affect your
Are you presently employed?
Do you expect to give advance notice to your
May we contact your present employer for
Have you ever worked for or applied for work at
this company before?
Have you ever been discharged for cause?
Have you ever been refused a surety bond or
ever had one cancelled?
Have you ever been convicted of any law violation,
except minor traffic violations?
Have you ever been disciplined for absenteeism?
Have you ever been disciplined for tardiness?
Explanations for answers given above, if necessary:
Education & Training
Give a complete account of your employment. BEGIN ON THE FIRST LINE WITH YOUR PRESENT OR MOST RECENT POSITION AND WORK BACK.
* If applying for a driving position, the U.S. Department of Transportation requires that driver applications show all employment for the past three years. They must also show commercial driver employment for the seven years immediately preceding this three year period. For this season, additional employment history information can be listed on the driver portion of the application.
Agreement and Acknowledgement
Read carefully before signing.
I certify that I have read and understood all of this employment application (including the driving portion if applicable). All information was provided by me and is true and correct to the best of my knowledge. I understand omissions or misrepresentations may result in rejection of my application or, if employed, may result in subsequent dismissal. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment, whether same is of record or not. I hereby authorize any former employer, person, school, firm or corporation listed hereon to answer any and all questions related to employment and agree to release from liability and hold all persons harmless for giving any and all truthful information within their knowledge or records. I understand this is a preliminary application and not a contract to employ me. Furthermore, if I am employed, my employment shall be completely voluntary and may be terminated at will at any time by either me or the company with or without notice for any reason not prohibited by law. I understand that no one other than the company president has authority to enter into any employment agreement to the contrary. I agree to take a drug/alcohol test when requested as a condition of employment. In the event the company advances me money or other things of value, I agree to repay the company and also that any amount still owing may be deducted from my final paycheck.
(Answer the question in this section only if applying for a driving position)
The U.S. Department of transportation requires that driver applicants state their date of birth.
Drivers Licenses held in past 3 years must be shown
A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
B. Has any license, permit or privilege ever been suspended or revoked?
C.Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations?
Accident Review for past 3 years
Traffic Convictions and Forfeitures for the past 3 years other than parking violations
Additional Employment History
This field is for validation purposes and should be left unchanged.