First Name
Last Name
Physical Address
Street Address
City
State/Province
ZIP/Postal Code
How long at current address?
Home Telephone
Cell Number
Position You Are Applying For:
Wage desired (be specific)
How many hours can you work weekly?
Date Available to Start Work:
EDUCATION: High School Name and location:
If yes, what year did you graduate or complete your GED?
College Name
College Location
Area of Study / Degree
If yes, what year did you graduate?
List Any Continuing Education / Professional Degrees / Certifications. Please list the name of the school, location of the school and degree achieved and date completed.
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation.
What is your means of transportation to work?
PROFESSIONAL / WORK REFERENCES
Please list two references other than relatives.
REFERENCE #1
First Name
Last Name
Position
Company
Street Address
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Phone
REFERENCE #2
First Name
Last Name
Position
Company
Street Address
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Phone
Please use this space to elaborate on any background, experience, or qualifications that you believe should be considered in evaluating your qualifications for employment. You may include hobbies, volunteer experience and any other activities you believe relevant. Please omit any information that would disclose your race, gender, age, marital status, ethnic origin, religious or political affiliations, or disability.
Military Background
Specialty
Date Entered:
Date Discharged:
Work Experience
Please list your work experience for the past seven years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.
Employer #1
Name of Employer
Street Address
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Phone
Supervisor
Start Date
End Date
Start Pay or Salary
Final Pay or Salary
Your last job tiitle
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Employer #2
Name of Employer
Street Address
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Phone
Supervisor
Start Date
End Date
Start Pay or Salary
Final Pay or Salary
Your last job tiitle
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Employer #3
Name of Employer
Street Address
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Phone
Supervisor
Start Date
End Date
Start Pay or Salary
Final Pay or Salary
Your last job tiitle
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
If not, who did?
APPLICATION FORM WAIVER
As indication that you have read and understood each sentence, please write your initials in the spaces provided below.
In exchange for the consideration of my job application by Fleet Truck, (hereinafter called “the Company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment,
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or to confer any right to remain an employee, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned,
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and that relationship cannot be altered except by a written instrument signed by the Owner/Managing Member of the Company.
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Both the undersigned and the company may end the employment relationship at any time, without specified notice or reason.
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If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.
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I authorize investigation of all statements contained in this application.
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I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.
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I hereby give the Company permission to contact schools, all previous employers (unless otherwise indicated), references and others and hereby release the Company from any liability as a result of such contact.
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I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics and mode of living.
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Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.
I further understand that my employment with the Company shall be probationary for a period of ninety (90) days and further that at any time during the probationary period or thereafter, my employment relationship with the Company is terminable at will for any reason by either party.
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Signature of Applicant
Date
Fleet Truck is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Fleet Truck Inc. depends solely on your qualifications.
Thank you for completing this application form and for your interest in our business.
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