English Application - Sander GrovesSander Groves

"*" indicates required fields

We do not discriminate on the basis of race, color, religion, national origin, sex, age, veteran status, sexual preference, marital status, non-job related disability or any other protected group status. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

Name*

First Middle Last

Home Phone*

Cell Phone*

Email*

Applicant Mailing Address*

Street Address Address Line 2 City State ZIP Code

What position are you applying for?*

What date would you be available to start work?

MM slash DD slash YYYY

If hired, can you furnish proof that you are eligible to work in the United States?*

Yes

What languages do you speak fluently?

What language is your preferred language for written and oral training?

Are you presently employed?

Yes

Have you ever been fired from a job or asked to resign?

Yes

Please explain

What is your desired pay range?

Are you willing to drive for the company?

Yes

Is your driving record clean for 3 years?

Yes

Please explain

What specific qualifications, if any, do you have for this position?

Education

High School Name

Location

Did you graduate/receive a diploma?

Yes

What were your main areas of study?

College/University Name

Location

Did you graduate/receive a degree?

Yes

What was your major or primary area of study?

Vocational/Trade School Name

Location

Did you graduate/receive a degree/certificate?

Yes

What was your primary area of study?

Work History

List names of employers in consecutive order with present or last employer listed first.

Name of Employer

Location

Position

Wage

Date employed (from)

MM slash DD slash YYYY

Date employed (to)

MM slash DD slash YYYY

Reason for leaving

Name of Employer

Location

Position

Wage

Date employed (from)

MM slash DD slash YYYY

Date employed (to)

MM slash DD slash YYYY

Reason for leaving

Name of Employer

Location

Position

Wage

Date employed (from)

MM slash DD slash YYYY

Date employed (to)

MM slash DD slash YYYY

Reason for leaving

References

Reference Name

First Last

Reference Phone

Relationship to you

Years known

Reference Name

First Last

Reference Phone

Relationship to you

Years known

Reference Name

First Last

Reference Phone

Relationship to you

Years known

Consent*

I have read, understand, and by my signature consent to these statements.

PLEASE READ EACH STATEMENT CAREFULLY BEFORE E-SIGNING

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also agree that any falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date. I authorize a thorough investigation of my past employment and activities, agree to cooperate in such investigation, and release from all liability or responsibility all persons and corporations requesting or supplying information. I further authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the job for which I am being considered or any future job in the event I am hired. I hereby agree to submit to any lawful drug, polygraph, integrity, or skill testing that may be required as a condition of employment or continued employment and understand that unless other wise prohibited by law, refusal to submit to such testing during the course of my employment may result in disciplinary action, up to and including discharge. I further agree to submit to search of my person or work
area that may be assigned to me and I hereby waive all claims for damages on account of such examination.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

I understand that my employment is terminable-at-will, and that this application is not, and is not intended to be, a contract for continued employment.

Signature*

Today's Date

MM slash DD slash YYYY