Application for Employment

First Name*

Last Name*

Email Address*

Phone No.*

Address*

City*

State*

Zip Code*

Drivers License No.*

Drivers License Type*

In case of emergency, who should we notify?*

Emergency Contact Phone No.*

Referral*

Have you ever filed an application here before?*

Yes
No

Have you ever been employed here before?*

Yes
No

If yes, reason for leaving?

Do any of your friends or relatives work here?*

Yes
No

If yes, list name(s):

General Information

Are you a citizen of the United States?*

Yes
No

If not, do you possess an Alien Registration Card?

Yes
No

If yes, give Alien Registration Number

Have you ever been convicted of a felony?*

Yes
No

If yes, explain:

Are you available to work?*

Yes
No

When are you available to start?*

Can you travel if job requires it?*

Yes
No

If millwright, do you have your own tools?

Yes
No

If CDL driver, date of last D.O.T. physical examination?

Any motor vehicle violations or accidents in the past 3 years?*

Yes
No

If Yes, list Below:

Have you ever been denied a license, permit or privilege to operate a motor vehicle?*

Yes
No

Has any license, permit or privilege ever been suspended or revoked?*

Yes
No

Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations?*

Yes
No

If yes, please explain:

Highest Level of Education*

Employment Record

Start with last or current position, including military experience and work back.

Current Employer

Supervisor

Address

Phone No.

Hire Date

Salary

Description of job and responsibilities:

Reason for leaving:

Current Employer

Supervisor

Address

Phone No.

Hire Date

Salary

Description of job and responsibilities:

Reason for leaving:

Summarize any special skills and qualifications acquired from employment or other experience:

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements may result in dismissal. I authorize Able Machinery Movers, LLC to make an investigation of any of the set forth information in this application.

I understand that employment at Able Machinery Movers, LLC is “at will”, which means that either l or Able Machinery Movers, LLC can terminate the employment relationship at any time with or without prior notice, and for any reason not prohibited by statute. All employment is continued on this basis. I understand that no supervisor, manager or executive of Able Machinery Movers, LLC other than the president, has any authority to alter the foregoing.

Applicant’s Signature*

Date*