Employment Application - Sunbelt Sealing, Inc

Sunbelt Sealing, Inc. Employment Application

WE ARE AN EQUAL OPPORTUNITY EMPLOYMENT COMPANY. WE ARE DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, CREED, COLOR, AGE, SEX, RELIGION OR NATIONAL ORIGIN, OR PHYSICAL HANDICAP.
APPLICANT INFORMATION
Name*
First Last
Date*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Social Security No.*
Date of Birth*
Month
Day
Year
Desired Salary*
Please enter a number greater than or equal to 0.
Valid Driver's License?*
- Yes
- No
Driver's License State*
Driver's License No.*
PREVIOUS EMPLOYMENT (Most Current)
Company*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Supervisor*
Job Title*
Starting Salary*
Ending Salary*
From*
Month
Day
Year
To*
Month
Day
Year
Responsibilities*
Reason for Leaving*
May we contact your previous supervisor?*
- Yes
- No
PREVIOUS EMPLOYMENT
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Supervisor
Job Title
Starting Salary
Ending Salary
From
Month
Day
Year
To
Month
Day
Year
Responsibilities
Reason for Leaving
May we contact your previous supervisor?
- Yes
- No
PREVIOUS EMPLOYMENT
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Supervisor
Job Title
Starting Salary
Ending Salary
From
Month
Day
Year
To
Month
Day
Year
Responsibilities
Reason for Leaving
May we contact your previous supervisor?
- Yes
- No
EMERGENCY CONTACT
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
DISCLAIMER AND SIGNATURE
All positions with Sunbelt Sealing, Inc. require physical demands such as stooping, crouching, kneeling, climbing, pushing, pulling, lifting, grasping, feeling, reaching, seeing and hearing. Also, all positions require that you be able to lift, push or pull up to 80 pounds of weight. Do you have any physical limitations that would keep you from being able to meet those demands? If so, explain in detail:*
Sunbelt Sealing, Inc. may require you to take a drug test at random. By signing this application, you are giving your permission for Sunbelt Sealing, Inc. to require you to take a drug test at any time while employed by Sunbelt Sealing, Inc. I hereby authorize and request any and all of my former employers and any other person, firm, or corporation to furnish any and all information concerning my credit-worthiness and personal background and I hereby release each such employer or other person, firm, or corporation from any and all liability by reason of furnishing the requested information. I understand that in connection with this application, a consumer report and/or an investigative report may be requested whereby information is obtained through personal interviews with my neighbors, friends, or associates, or with others with whom I am acquainted or who may have knowledge with respect to my character, general reputation, personal characteristics and mode of living, and hereby authorize the procurement of any such report. I understand that, upon my request, I have the right to know if any such report was requested and, if so, the name and address of a consumer reporting agency that furnished such report and in the case of a consumer investigative report, that I may inspect and receive a copy of such report by contacting such agency. I also understand that I have the right to receive a complete and accurate disclosure of the nature and scope of the information requested if I request such disclosure within a reasonable period of time. I understand that if employed: 1) Any misrepresentation or omission of facts requested in this application is cause for dismissal; and 2) my employment is for no definite period and I may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice. I certify that my answers are true and complete to the best of my knowledge*

Type name as signature.
PRE-EMPLOYMENT NOTIFICATION
This is a notification that I have read and understand the policy of Sunbelt Sealing, Inc. As an employee for Sunbelt Sealing, Inc., I understand that the company will pay for my pre-employment drug test and any other information needed to further my application of employment. For any reason if my employment is terminated or I voluntarily resign before a period of 90 days, I will reimburse Sunbelt Sealing, Inc. for any pre-employment expenses. As an employee for Sunbelt Sealing, Inc., I understand that there will be travel and out of town work to be done. At Sunbelt Sealing, Inc., employees are sometimes required to go out of town and stay overnight for extended periods of time. As an employee for Sunbelt Sealing, Inc., I understand that after my probationary period of ninety (90) days, I may be eligible for uniforms if I choose to take them. If I choose to do so, I will be issued 11 sets. I understand that the charge for uniforms is $9.00 per week to be deducted from my payroll; and I will be responsible for turning them in to the Company when I resign or if I am terminated. Should I fail to turn them in to the Company I will be charged $23 per shirt and $25 per pair of pants.*

Type name as signature.

Sunbelt Sealing, Inc. Employment Application

WE ARE AN EQUAL OPPORTUNITY EMPLOYMENT COMPANY. WE ARE DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, CREED, COLOR, AGE, SEX, RELIGION OR NATIONAL ORIGIN, OR PHYSICAL HANDICAP.

APPLICANT INFORMATION

PREVIOUS EMPLOYMENT (Most Current)

PREVIOUS EMPLOYMENT

PREVIOUS EMPLOYMENT

EMERGENCY CONTACT

DISCLAIMER AND SIGNATURE

PRE-EMPLOYMENT NOTIFICATION