Application For Employment


Instructions: Please enter your information. Answer all questions.


Position

Indicate desired position.

Rate of Pay Expected

Please indicate if hourly, weekly, monthly, etc.


Personal Information





























If you are under age 18, do you have an employment/age certificate? *

No
Have you ever been employed with us before? *

No
Are you currently employed? *

No
May we contact your present employer?

No
How did you learn about us? *







Availability


What date are you available to start work? *



Hours Available *



For specific Day/Hour availability, please enter information below.



Military Service Record


Have you ever served in the armed forces? *





To




In accordance with applicable law, we consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, sexual orientation, disability, or any other legally protected status. WE ARE AN EQUAL OPPORTUNITY EMPLOYER.


High School


Name and Location


Undergraduate College University


Name and Location

Years Completed

Degree

Describe Course of Study or Major


Graduate / Professional


Name and Location

Years Completed

Degree

Describe Course of Study or Major

List professional, trade, business or civic activities and offices held.

You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, disability or any other protected status.

Describe any specialized training, apprenticeship, skills and extra-curricular activities:

Describe any honors you have received:

State any additional information you feel may be helpful to us in considering your application:


Reference



Give name, address and telephone number of three references who are not related to you and are not previous employers.

Reference 1

Name
Address
Phone


Reference 2

Name
Address
Phone


Reference 3

Name
Address
Phone


Emergency Contact
























Current or Most Recent Position


Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.

Employer: *


Address: *


Supervisor: *






Job Title

Start Date

To
End Date


Work Performed *


Beginning Rate *



Enter starting hourly rate or salary.

Ending Rate *



Enter ending hourly rate or salary.

Reason for Leaving: *




Previous Position


Employer:


Address:


Supervisor:






Job Title

Start Date

To
End Date


Work Performed

Beginning Rate



Enter starting hourly rate or salary.

Ending Rate

Enter ending hourly rate or salary.

Reason for Leaving: *



Additional Previous Position


Employer:


Address:


Supervisor:






Job Title

Start Date

To
End Date


Work Performed

Beginning Rate



Enter starting hourly rate or salary.

Ending Rate

Enter ending hourly rate or salary.

Reason for Leaving:


1. Do you have a valid driver's license?



Leasing positions require reliable transportation and a current driver’s license.


Special Skills and Qualifications

Summarize special job-related skills and qualifications acquired from employment or experience.

2. List any special experience, qualifications or skills you have that you believe would help you do the job applied for:
3. Other than driver's license, list any special licenses or certifications you have that you believe would help you do the job applied for: (List licensing authority, license number and date
4. List any experience you have in operating business or mechanical equipment that you believe would be useful in the job applied for:

Applicants Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.


Do you agree with the above APPLICANT'S STATEMENT? *

Date *



UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND ANY APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. ANY EMPLOYER WHO VIOLATES THIS PROVISION IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT TO EXCEED $100.00.

I have read the above statement concerning Maryland Law. *

Date *




Information For Applicatant

  1. This application is valid for only thirty (30) days. If you have not been employed by the Company within thirty (30) days of your application, you must re-apply for an open position.
  2. By my signature below, I agree to the following:
    1. I consent to take any physical examinations, including but not limited to tests for alcohol or drugs, that may be requested by the Company in connection with the processing of my application for employment. I further authorize any health care professional who performs such an examination or who has other information concerning my physical, mental or other medical status to release information to the Company.
    2. I understand that any false statements or misleading omissions made by me in connection with my application, or in responding to the Company’s requests for information, is sufficient grounds for my rejection as a candidate for employment or for my immediate discharge if employed.
    3. I understand that any employment with the Company is at-will and of indefinite duration, and that either I or the Company can terminate that employment at any time with or without notice for any or no reason, and that no agreement to the contrary will be recognized by the Company unless made in writing and signed by an officer of the Company. I understand that satisfactory completion of my provisional period will not change my status as an at-will employee.
    4. I understand that none of the Company’s practices or policies are to be construed as imposing any binding obligations on the Company, and that they are subject to revision, addition or deletion at any time. e. I hereby authorize the Company to obtain from schools, former employers, or other individuals or institutions it contacts any information in their possession regarding my employment history or qualifications for the job for which I have applied. I further release, promise to hold harmless, and covenant not to sue the Company on the basis of its attempts to obtain information from my previous and present schools and employers, or other individuals or institutions it contacts regarding my employment history or qualifications for the job for which I have applied.
    5. I understand that should I be offered a position with the Company, it will be contingent upon the results of a background check, including but not limited to an investigation into my credit history, criminal background, driving record, and other relevant background information. I authorize the Company and its authorized vendor(s) to conduct such a consumer background investigation to the extent permitted by law.
I have read this Employment Application and fully understand its terms. *

Enter your initials below to further confirm your understanding of these terms.

Initial

Date *