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Name *
Home Phone *
Home Phone
Address *
Employment Desired *
Desired Start Date
Desired Start Date
Have you ever applied to our company before? *
Have you ever worked for our company before? *
Are there any days or hours you would be unable or unwilling to work? *
Name, Location & Dates Attended (if applicable)
Name, Location & Dates Attended (if applicable)
Name, Location & Dates Attended (if applicable)
Have you ever served in the military? *
Are you willing and able to perform all of the tasks required by the job you are applying for?
Will you abide by the safety rules of this company? *
Have you ever been disciplined for violating company safety rules or regulations? *
Are you willing and able to report to work on time every day on a regular basis? *
Name of employer: Name and title of supervisor: Telephone: Dates employed: Job title: Duties: Pay starting: Pay ending: Reason for leaving:
Are you currently employed? *
May we contact your current employer (if currently employed)?
I authorize investigation of all statements contained in this application. I understand the misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no certain period and regardless of the rate of payment of my wages and salary, may be terminated at any time without any prior notice. I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or if hired, dismissal. I authorize any of the persons or organizations referred to in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties from all liability for any damage that may result from furnishing such information to you. I authorize you to request and receive such information, and I will indemnify you against any liability that may result from making such investigation. As a condition of my employment with Quality Refrigerated Services, I agree that all information which I receive in the course of my employment relating in any manner to, among other things, the business activities, production processes, financial affairs, programs, concepts or designs of Quality Refrigerated Services are to be treated by me as trade secrets and kept in confidence, not to be disclosed to any unauthorized person either during or after my employment, or used by me in any manner adverse to the interests of Quality Refrigerated Services. In consideration for my employment by your company, I agree to conform to the rules and regulations of the company and acknowledge that these rules and regulations may be changed, interpreted, suspended, withdrawn, or added by your company at any time, at the company's sole option and without any prior notice to me. I further acknowledge that my employment may be terminated, and any offer of employment, if such is made, or my acceptance of an employment offer, if such is to occur, may be withdrawn, with or without cause, and with or without prior notice, at any time, at the option of the company or myself. I understand that no representative of the company other than the President or Chairman of the Board, and then only in writing, has any authority to enter into any agreement for employment for any specified period of time or to assure any other personnel action, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or make any agreement contrary to the foregoing. I understand that nothing contained in this employment application or in the grating of an interview is intended to create an employment contract between Quality Refrigerated Services and myself for either employment or for providing any benefit. I acknowledge that any offer of employment to me by Quality Refrigerated Services is contingent upon my timely completing INS Form I-9 and producing the proper documents required by he Immigration reforming Control Act of 1986. My failure to meet these requirements within the specified time will result in the termination of employment. I acknowledge that I have been advised that this application will remain active for no more than sixty (60) days from the date it was made. Please sign/type your first and last name if you agree to these terms and conditions:
Date Signed *
Date Signed