Non-Driver's Application for Employment

IN COMPLIANCE WITH FEDERAL AND STATE EQUAL EMPLOYMENT OPPORTUNITY LAWS, QUALIFIED APPLICANTS ARE CONSIDERED FOR ALL POSITIONS, WlTHOUT REGARD TO RACE, COLOR RELIGION, SEX, NATIONAL ORIGIN, AGE, MARITAL STATUS, OR NON-JOB-RELATED DISABILITIES.

Date of Application *

Desired Wage (Hourly) *

License Number *

State *

Class *

PERSONAL INFORMATION

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Phone Number *

Social Security Number *

Date of Birth *

Are you eligible to work in the United States? *

Are you under the age of 18, do you have an employment/Age certificate? *

Have you been convicted, or pleaded "no contest" to a felony? *

If yes, please explain:

POSITION AVAILABILITY

Position applied for: *

Days & Hours Available:

Days Available:

Hours Available: Monday

From: *

To: *

Hours Available: Tuesday

From: *

To: *

Hours Available: Wednesday

From: *

To: *

Hours Available: Thursday

From: *

To: *

Hours Available: Friday

From: *

To: *

Hours Available: Saturday

From: *

To: *

Hours Available: Sunday

From: *

To: *

What date are you available to start working? *

EDUCATION

School Name *

School Address *

Address Line 1

City

State

Degree / Diploma *

Graduation Date *

Skills & Qualifications: license, skills, training, awards, etc.

EMPLOYMENY HISTORY

Current Employer Name / Company *

Address *

Address Line 1

City

State

Zip Code

Contact Person *

Contact Phone Number *

Position Title *

Employment Date: From *

Employment Date: To *

May we contact your present employer? *

Previous Employer

Employer Name / Company

Address

Address Line 1

City

State

Zip Code

Contact Person

Contact Phone Number

Position Title

Employment Date: From

Employment Date: To

Previous Employer

Employer Name / Company

Address

Address Line 1

City

State

Zip Code

Contact Person

Contact Phone Number

Position Title

Employment Date: From

Employment Date: To

PERSONAL REFERENCES

Personal Reference 1

Name

Phone

Address

Address Line 1

City

State

Personal Reference 2

Name

Phone

Address

Address Line 1

City

State

Personal Reference 3

Name

Phone

Address

Address Line 1

City

State

TO BE READ AND SIGNED BY APPLICANT

This certifies that I completed this application and that all entries and information are true and complete to the best of my knowledge.

I authorize Al Smith Rigging to make such investigations and inquiries of my personal, employment, financial and medical history, and any other related matters, as may be necessary for arriving at an employment decision.

I further authorize Al Smith Rigging permission to secure an Abstract of Driving Record (MVR) from the state issuing my DL, or shall furnish it upon request. I hereby release employers, schools, health care providers, and others persons from all liability in responding to inquiries and releasing information in connection with this application.

In the event of employment, I understand that false or misleading information given on this application, or interview(s), may result in immediate termination of employment.

Applicant's Signature *

Clear Signature

Date *

Non-Driver Application

Non-Driver's Application for Employment

PERSONAL INFORMATION

POSITION AVAILABILITY

Days & Hours Available:

Hours Available: Monday

Hours Available: Tuesday

Hours Available: Wednesday

Hours Available: Thursday

Hours Available: Friday

Hours Available: Saturday

Hours Available: Sunday

EDUCATION

EMPLOYMENY HISTORY

Previous Employer

Previous Employer

PERSONAL REFERENCES

Personal Reference 1

Personal Reference 2

Personal Reference 3

TO BE READ AND SIGNED BY APPLICANT