United States Driver's License
Resume:
Tomkiw Enwright, plc ©
Date
APPLICATION FOR EMPLOYMENT
(AN EQUAL OPPORTUNITY EMPLOYER)
We will not discriminate based upon race, color, religion, sex, national origin, citizenship, age, height, weight, marital status, veteran status, handicap, or any other protected category. Individuals with disabilities may request accommodation in the application process. Name Social Sec. No.
LAST FIRST MIDDLE
Present Address
STREET CITY STATE ZIP
Permanent Address
STREET CITY STATE ZIP
Telephone No. Email Address
Are you 18 years or older? Yes No
Are you a U.S. Citizen? Yes No
Are you authorized to work in the United States? Yes No Do you have reliable transportation? Yes No
Do you smoke? Yes No
Have you ever been convicted of a crime? Yes No
If so, When? Where?
What was the nature of the offense?
Are there any felony charges pending against you? Yes No U.S. Military or Rank Upon Type of
Naval Service Discharge Discharge
Duties:
EMPLOYMENT DESIRED
Position Applied For?
Date You Can Start Salary Desired
Have you ever applied to or worked for this Company before? Yes No Where? When?
Tomkiw Enwright, plc ©
How / Where did you hear about this opportunity? EDUCATION
NAME Number Of Did You Reason For Location
Years Attended Graduate? Leaving?
HIGH
SCHOOL
COLLEGE
OTHER (include Trade or Vocational Schools, and education gained in the Military) EMPLOYMENT HISTORY
LIST ALL FORMER AND CURRENT EMPLOYERS WITHIN THE PAST 10 YEARS
(If Employed, list all former employers with the most recent employer first) Name Of Employer:
Address Of Employer:
Employ. Dates
Start & End
Position(s) Held
Salary -
Start & End
Name & Phone # of
Immed. Supervisor
State each and every
Reason for Leaving
Name Of Employer:
Address Of Employer:
Employ. Dates
Start & End
Position(s) Held
Salary -
Start & End
Name & Phone # of
Immed. Supervisor
State each and every
Reason for Leaving
Name Of Employer:
Address Of Employer:
Employ. Dates
Start & End
Position(s) Held
Salary -
Start & End
Name & Phone # of
Immed. Supervisor
State each and every
Reason for Leaving
BE SURE YOU HAVE NOT OMITTED ANY EMPLOYER REGARDLESS OF DURATION AND NATURE. Tomkiw Enwright, plc ©
(Use extra paper, if necessary)
Professional or Academic REFERENCES
(Please list names, addresses & phone no. for persons not related to you, whom you have known at least 1 year) Please include persons who have known you in a business or academic setting. Examples: Former Boss, Teacher, Professor, etc. 1.
2.
3.
I authorize the references and employers listed above to provide you any and all information concerning my previous employment and any pertinent information they may have, and release you and all parties from any liability for any damages that may result from furnishing same to you. I waive any written notice of the release of such information to the Company.
SIGNATURE DATE
DRIVERS’ LICENSE INFORMATION
Answer the following question(s) only if the box next to the question is checked. Do you currently hold a valid driver's license? Yes No If no, please explain:
List the following for each current valid driver's license you hold. STATE LICENSE NUMBER EXP. DATE CLASS
STATE LICENSE NUMBER EXP. DATE CLASS
During the past five years have you had any driver's license not listed above? Yes No If yes, for each list:
STATE LICENSE NUMBER EXP. DATE CLASS
STATE LICENSE NUMBER EXP. DATE CLASS
Has your driver's license, permit, or driving privilege ever been denied, suspended or revoked? Yes No
If yes, explain:
Tomkiw Enwright, plc ©
PLACES OF RESIDENCE INFORMATION
Please list any and all addresses where you have lived for the past ten years: Use the back of this form if necessary.
Address City State/Zip Dates From/To
1. 2. 3. 4. 5. DISCLOSURE
1. I authorize the Company to make whatever inquiries it may deem necessary in connection with my application for employment. As part of such inquiries, the Company has my permission to contact persons who may have information relating to my suitability for employment and to secure consumer reports (including investigative consumer reports). 2. I authorize and instruct any person or agency contacted to participate or conduct inquiries at its request, to compile information, and to furnish any information obtained as a result of such inquiries whether or not such information is part of their records. I further authorize the Company, in its sole discretion, to furnish copies of this authorization and my application to any person(s) and/or consumer reporting agency or agencies in connection with the above purposes. I agree to release you and all parties form any liability for any damages that may result from furnishing such information. Information contained in reports obtained by the Company in accordance with the above authorization may include information pertaining to your character, general reputation, police record, personal characteristics, and mode of living. You have the right to request that the Company completely and accurately disclose to you the nature and scope of all investigations requested. Such a request must be made in writing to the personnel department within a reasonable period of time after your application for employment is received. If employment is denied on the basis of information contained in a credit report, the company will advise you of its decision and provide the name and address of the credit reporting agency that made the report. 3. I certify that the information in this application is complete and correct to the best of my knowledge and understand that any falsification, misrepresentation, or omission of this information is grounds for a rejection of this Application or dismissal of any employment if I am hired.
4. I authorize the Company to release any information requested by any of my prospective or subsequent employers without any obligation to give me written notice of such disclosure and, in consideration of it's efforts to provide information, hereby release the Company and its agents from any liability whatsoever as a result of any such inquiries and disclosures. 5. If employed, I understand that if I am or become handicapped in need of accommodations for employment, I must notify the President of the Company in writing within 182 days after the need is known. 6. In consideration of my employment, I agree to conform to the rules and regulations of the Company, and I agree that my employment and compensation can be terminated at any time with or without cause and with or without notice at the option of either the Company or myself. I understand that no officer or representative of the Company has the authority to enter into an agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing, except the President of the Company, and any such agreement must be made in a signed writing directed to me personally. I further Tomkiw Enwright, plc ©
acknowledge that no one has made any representations or statements contrary to the company's at-will policy to me, either orally or in writing, and I acknowledge and understand that no one has the authority to make such representations or statements to the contrary in the future.
7. In further consideration the Company’s review of my application and possible subsequent employment, I agree that any claim or lawsuit arising out of my employment with or my application for employment with the Company or any of its subsidiaries must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. While I understand that the statute of limitations for claims arising out of any employment action may be longer than six (6) months, I agree to be bound by the six (6) month period of limitations set forth herein, and I WAIVE ANY STATUTE OF LIMITATIONS TO THE CONTRARY. Should a court determine in some future lawsuit that this provision allows any unreasonably short period of time to commence a lawsuit, the court shall enforce this provision as far as possible and shall declare the lawsuit barred unless it was brought within the minimal reasonable time within which the suit should have been commenced.
I HEREBY ACKNOWLEDGE THAT I HAVE READ, I UNDERSTAND, AND I AGREE TO THE TERMS OF EACH OF THE ABOVE SEVEN (7) INDIVIDUAL STATEMENTS. DATE: SIGNATURE
Tomkiw Enwright, plc ©
Feel free to use this space to tell us anything about your education, experience, work habits, attendance and/or personal strengths that make you a superior candidate.
Contact this candidate