Application for Employment

Select a date

First name

Last name

Phone

Address

How long have you lived at this address?

Position desired

Salary desired

When are you availble to start?

Have you ever been convicted of a crime?

Yes

If yes, please provide an explainatio including the specific nature of the offense(s), when, and where the crime took place. NOTE: A conviction record will not necessarily be a bar to employment. Applications are not required to disclose sealed or expunged records of convictions or arrests.

School name, location, and years attended

Current licenses and/or certifications

What language(s), other than English, do you speak?

Please list your employment history for the past five (5) years

Employment History

Name of current/most recent employer

City & State

Supervisor's name

Supervisor's phone number

May we contact your current employer/supervisor?

Yes

Employment start date & end date

Starting salary

Ending salary

Reason for leaving?

List the job titles you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Additional Employer

Employer Name

City & State

Supervisor's name

Supervisor's phone number

Employment start date & end date

Starting salary

Ending salary

Reason for leaving?

List the job titles you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Additional Employer

Employer name

City & State

Supervisor's name

Supervisor's phone number

Employment start date & end date

Starting salary

Ending salary

Reason for leaving?

List the job titles you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Additional Employer

Employer name

City & State

Supervisor's name

Supervisor's phone number

Employment start date & end date

Starting salary

Ending salary

Reason for leaving?

List the job titles you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

References

Reference name, relationship, and contact information

Anything else you'd like us to know about you?

APPLICATION FORM WAIVER

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give GIFT SEPTIC SERVICE, LLC (the Company)permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.

Federal laws require that employers hire only individuals who are authorized to be lawfully in the United States. In compliance with such laws, all offers of employment are subject to verification of each applicant’s identity and employment authorization. I understand that it will be necessary for me to submit such documents as are required by law to verify my identification and employment authorization on the first day of employment.

I further understand that my employment shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation is terminable at will for any reason by either party.

GIFT SEPTIC SERVICE, LLC is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with us depends solely on your qualifications.

Thank you for applying to Gift Septic Service!