Job Application

Employment Application

Federal law prohibits discrimination in hiring or employment on the basis of race, color, sex, religion, disability, national origin, citizenship, or on the basis of age. No question on this application is intended to secure information to be used for such discrimination. Proof of identity and work authorization will be required upon employment in accordance with federal regulations. This Company intends to check and hold you responsible for the accuracy of the statements you make on this application. This application will receive consideration for thirty (30) days. If you have not heard from the Company within thirty days, and wish to receive further consideration for employment, you must reapply in person.

PERSONAL DATA
Last Name	First Name	Middle Name
Are you 18 years or older?	If no, list date of birth:
Street	City	State Zip code
Phone Number Email Address

EDUCATIONAL DATA
Enter Highest Grade Completed:	Junior High or High School	College or University	Graduate School

Type of School High School	Name of School	Location	Major Subject or Course of Study	Did you graduate?
College
Business or Trade School
Correspondence School
Other (Specify)
Graduate School
List Degree(s) Obtained:

EMPLOYMENT
Job applied for Salary desired
Are you employed now? If so, may we contact your present employer?
Have you ever applied here before? When?
Have you ever worked for this Company before? When?
Are you restricted to working only certain hours of the day? If yes, indicate the hours you are available
Are you restricted to working certain days of the week? If yes, indicate the days you are available:
Mark days available with an "X": M T W Th F Sa Su
When can you report to work?
Type of employment desired?

WORK HISTORY
Period of Employment (Mo/Yr)	From:	To:
Name and Address of Company	Company:	Street & No.:	City & State:
Positions Held or Duties Performed
Rate of Pay	Start:	Final:
Name of Supervisor at time of separation: Phone:
Reason for leaving:


Period of Employment (Mo/Yr)	From:	To:
Name and Address of Company	Company:	Street & No.:	City & State:
Positions Held or Duties Performed
Rate of Pay	Start:	Final:
Name of Supervisor at time of separation: Phone:
Reason for leaving:


Period of Employment (Mo/Yr)	From:	To:
Name and Address of Company	Company:	Street & No.:	City & State:
Positions Held or Duties Performed
Rate of Pay	Start:	Final:
Name of Supervisor at time of separation: Phone:
Reason for leaving:

RELATIVES IN OUR EMPLOYMENT
Name Relationship
Name Relationship
Name Relationship
Name Relationship

REFERENCES
Give three references who are not relatives or former employers.
Name	Occupation	Years Known	Phone	Address

AFFIDAVIT
I authorize, without liability, investigation of all statements in this application. I authorize all schools which I attended and all previous employers to furnish to the Company my record, reason for leaving and all information they may have concerning me, and I hereby release them and the Company from all liability for any damage whatsoever arising therefrom. I understand that the Company may investigate my driving record, criminal record, and credit history. I understand I will be notified if such an investigative report is obtained and that I will have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of information concerning the nature and scope of the investigation. I expressly waive all provisions of law prohibiting any physician, person, hospital, or other institution that has or may hereafter attend to or furnish me with treatment from disclosing to the Company any knowledge or information hereby acquired. I understand that in event of my employment by the Company, it shall be sufficient cause for dismissal if any of the information I have given in this application is false or if I have failed to give any information herein requested. I understand that proof of identity and work authorization will be required upon employment in accordance with federal regulations. In event of my employment by the Company, I agree to abide by all present and subsequently issued rules of the Company. I understand and agree that, if hired, my employment is “at will”. This means that either I or the Company may end the employment relationship at any time and for any or no reason. By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
Signature Date

AFFIDAVIT

I authorize, without liability, investigation of all statements in this application. I authorize all schools which I attended and all previous employers to furnish to the Company my record, reason for leaving and all information they may have concerning me, and I hereby release them and the Company from all liability for any damage whatsoever arising therefrom.

I understand that the Company may investigate my driving record, criminal record, and credit history. I understand I will be notified if such an investigative report is obtained and that I will have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of information concerning the nature and scope of the investigation.

I expressly waive all provisions of law prohibiting any physician, person, hospital, or other institution that has or may hereafter attend to or furnish me with treatment from disclosing to the Company any knowledge or information hereby acquired.

I understand that in event of my employment by the Company, it shall be sufficient cause for dismissal if any of the information I have given in this application is false or if I have failed to give any information herein requested. I understand that proof of identity and work authorization will be required upon employment in accordance with federal regulations. In event of my employment by the Company, I agree to abide by all present and subsequently issued rules of the Company.

I understand and agree that, if hired, my employment is “at will”. This means that either I or the Company may end the employment relationship at any time and for any or no reason.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Signature Date

CRIMINAL BACKGROUND
Have you ever pleaded guilty to, “no contest” to, or been convicted of a crime other than a minor traffic violation?
If “yes”, please state citation, date, and place where offense occurred (A “yes” answer will not automatically disqualify you from consideration.)

DRIVING INFORMATION
Do you have a current driver’s license?
State: Lic. No.: Expiration Date:
Has your driver's license ever been suspended or revoked?
If “yes", please explain circumstances:
Please list all moving traffic violations in the past five (5) years:
Offense Date Location
Offense Date Location
Offense Date Location
Offense Date Location

SPECIAL SKILLS
What knowledge, special training or computer skills, and/or other qualifications have you acquired from employment or other experience? Include any specific equipment that you can proficiently operate.

If an employment offer is made, the company reserves the right or may perform drug testing or a background check, and the job offer and/or continued employment is contigent upon a passed drug test and/or acceptable background check.

TESTING OF APPLICANTS
All applicants considered final candidates for positions with R. L. Morrison & Sons, Inc. will be tested for the presence of illegal drugs as part of the application process. Applicants will be advised of the Company’s pre-employment testing requirements in writing prior to an offer of hire. Applicants will be required to sign an Applicant Drug Testing Consent Agreement. If an applicant refuses, he or she will not be considered for employment, and the employment application process will be terminated. If an applicant’s test is positive, the applicant will not be considered for employment at that time and will be informed that he or she has failed to meet employment standards. If the applicant asks what substance was detected by the test, he or she shall be told in confidential manner. Any applicant who refuses to submit to, tampers with, or fails to pass the pre-employment drug test shall be ineligible for hire until such time as the applicant can demonstrate that he/she is no longer using drugs illegally and is receiving treatment for drug addiction or has been successfully rehabilitated, in no case will this be less than (6) months from initial incident.
By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
Applicant's Signature Signature