Please TYPE or PRINT clearly. To be considered for employment, this Employment Application must be completed and signed personally by the applicant. Each question must be answered in full, even if a resume is provided. If an answer is NO or NOT APPLICABLE, indicate such.
We are an Equal Opportunity Employer. We consider all applications for all positions without regard to race, religion, creed, color, sex, age, national origin, disability, sexual orientation, marital or familial status, pregnancy, military status, veteran status, predisposing genetic characteristics or carrier status, arrest or conviction record, domestic violence victim status, or any other protected class or status. Applicants requiring a reasonable accommodation to participate in the application and/or interviewing process should notify an organization representative.
BIOGRAPHICAL DATA
If yes, give dates.
Employment eligibility will be verified upon employment.
EDUCATIONAL BACKGROUND
High School
College
Other
SKILLS
(Provide your driver's license ID number ONLY if it is a requirement of the position for which you are applying)
EMPLOYMENT HISTORY
Present or Last Employer
Next Previous Employer
Next Previous Employer
Next Previous Employer
REFERENCES (List three references other than relatives)
CONVICTION RECORD STATUS
All applicants and employees must, as a condition of employment, inform the organization of all convictions. This includes all convictions received within the past seven years, while your application for employment is pending, and within seven days of receiving a conviction if currently employed.
If you answered ‘yes’ and have been convicted of a felony or misdemeanor, please provide additional information below, such as the crime(s), date(s), court location, sentencing information, disposition of sentence, and rehabilitation completed. Please note that a ‘yes’ answer to this question does not necessarily disqualify an applicant for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime as it relates to the job applied for, and rehabilitation will be considered. The organization reserves the right to reject individuals for employment based on job-related convictions.
PLEASE READ CAREFULLY AND SIGN BELOW (LAST STEP AFTER ENTIRE FORM IS COMPLETED)
I hereby certify that all of the information I have provided on this Employment Application is true and correct to the best of my knowledge. I understand that any misrepresentation or omission of facts will disqualify me from further consideration of employment, withdrawal of any offer of employment, or, termination of employment, if already hired.
I authorize verification of all of the information I have provided on this Employment Application and understand that additional information may be needed to consider my application for employment. I authorize all previous employers, educational institutions, references, and other persons who have knowledge of me or my records to provide any and all information pertinent to my employment and release the same from any liability resulting from providing such information. I also release this organization and all of its employees from all liability for any damage that may result from reliance on the information furnished.
I authorize permission to secure an Abstract of Driving Record (MVR) from the State issuing my CDL, or shall furnish it upon request.
The organization is committed to providing a drug and alcohol-free workplace. After receiving a conditional offer of employment, I understand that a drug test will be required before starting work. If the results of the test are positive, I understand that the offer of employment will be withdrawn.
I understand that if employed, I am required to abide by all policies, procedures, rules, and regulations of the organization. I also understand and agree that, if hired, my employment is “at-will” and is for no definite period and may, regardless of the date of payment of my wages or salary, be terminated by myself or the organization at any time with or without cause or notice.
APPLICANTS FOR POSITIONS TO DRIVE A COMMERCIAL MOTOR VEHICLE ONLY
All applicants for positions requiring the operation of a Commercial Motor Vehicle must complete the following information. A ‘Commercial Motor Vehicle’ includes vehicles with a gross vehicle weight rating (GVWR) of more than 26,000 pounds; drivers of vehicles designed to transport sixteen (16) or more passengers, including the driver; and drivers of vehicles used to transport hazardous materials, regardless of whether the vehicles operate interstate or intrastate.DRIVER LICENSES
DRIVING EXPERIENCE – IF NONE, WRITE ‘NONE’
Straight Truck
Tractor and/or Semi-Trailer
Tractor – Two Trailersr
Motor coach and/or School Bus
Other
LIST ALL TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) – IF NONE, WRITE ‘NONE’ (ATTACH SHEET IF MORE SPACE IS NEEDED)
MEDICAL QUALIFICATION: