Employment

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General Information
Last Name:    First Name:    Phone:
Address:
City:    State:    Zip:
Email Address:


Employment Desired
Position:
Date you can start:    Salary Desired:
Are you at least 18 years old: Yes   No
If not, what is your age for labor law purposes:

Are there any days or hours you will NOT work:
Are you available for out of town work: Yes   No
Will you work overtime: Yes   No
Ever applied or been employed by us before? When?:


Educational Information
  NAME OF SCHOOL YEARS ATTENDED GRADUATE SUBJECTS STUDIED
HIGH SCHOOL
COLLEGE
TRADE SCHOOL
OTHER


Employment History
  NAME, ADDRESS SALARY DUTIES REASON FOR LEAVING
FROM:
To:
FROM:
To:
FROM:
To:
FROM:
To:


References Give the names of three persons not related to you whom you have known at least one year.
NAME CITY, PHONE BUSINESS YEARS ACQUAINTED
In case of emergency, notify:    Phone:


ONLY U.S. CITIZENS OR ALIENS WHO HAVE A LEGAL RIGHT TO WORK IN THE U.S. ARE ELIGIBLE FOR EMPLOYMENT. CAN YOU, UPON EMPLOYMENT, PROVIDE GENUINE DOCUMENTATION ESTABLISHING YOUR IDENTITY AND ELIGIBILITY TO BE LEGALLY EMPLOYED IN THE UNITED STATES?
Yes   No
HAVE YOU EVER BEEN CONVICTED OF A CRIME OR VIOLATION OTHER THAN MINOR TRAFFIC VIOLATIONS? (A CONVICTION RECORD WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT), (DO NOT INCLUDE RECORDS THAT HAVE BEEN SEALED)   Yes   No
IF YES, PLEASE EXPLAIN.   

I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED MY APPLICATION MAY BE REJECTED, AND IF I AM EMPLOYED, I WILL BE SUBJECT TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION.

WITH THE EXCEPTION OF CONTACTING MY CURRENT EMPLOYER, (UNLESS AUTHORIZED ABOVE), I FULLY AUTHORIZE THE INVESTIGATION AND VERIFICATION OF ANY STATEMENTS MADE BY ME IN THIS EMPLOYMENT APPLICATION (AND ANY RESUME OR OTHER MATERIALS SUBMITTED BY ME IN CONNECTION WITH MY EFFORT TO OBTAIN EMPLOYMENT WITH ACTION BARRICADE LLC.) I EXPRESSLY AUTHORIZE ACTION BARRICADE LLC AND ITS DESIGNEES TO CONTACT ALL LISTED PAST EMPLOYERS AND/OR REFERENENCES. I FURTHER AUTHORIZE ANY PERSON, SCHOOL, PAST EMPLOYER, ORGANIZATION, OR OTHER ENTITY LISTED IN MY APPLICATION AND ANY RESUME OR OTHER MATERIALS SUBMITTED BY ME TO PROVIDE ACTION BARRICADE LLC WITH ANY INFORMATION REQUESTED THAT MAY BE RELEVANT AND USEFUL IN MAKING A HIRING DECISION. I EXPRESSLY RELEASE ANY SUCH PERSONS, ORGANIZATIONS, OR ENTITIES, INCLUDING ACTION BARRICADE LLC AND ITS DESIGNEE, FROM ANY AND ALL LIABILITY FOR MAKING DISCLOSURE OR OBTAINING ANY INFROMATION ABOUT ME WHICH IS NOT PROHIBITED BY LAW TO RELEASE.

I UNDERSTAND THAT THIS APPLICATION IS NOT INTENDEND NOR IS IT AN OFFER OF EMPLOYMENT OR EMPLOYMENT CONTRACT. FURTHER, I UNDERSTAND THAT ANY SUBSEQUENT EMPLOYMENT AT ACTION BARRICADE LLC IS “AT-WILL” AND MY BE TERMINATED BY THE COMPANY OR EMPLOYEE WITH OR WITHOUT NOTICE AND WITH OR WITHOUT CAUSE.

 

Signature:

 

Action Barricade