Employment Application - Boer's Transfer and Storage

APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS

Date

Name*

First Middle Last

Address

Street Address City State ZIP Code

How long have you lived there?

Social Security No.

Phone*

Cell

Other

Email*

Are you 18 years of age or older*

Yes
No

Position Applied for

Salary Desired

Days/hours available to work

How many hours can you work weekly?

Can you work nights?

Employment desired*

FULL-TIME ONLY
PART-TIME ONLY
FULL- OR PART-TIME

What date are you available to start work?*

Are you a U.S. citizen or eligible to work in the United States?

YES
NO

Education

By type of school

High School

NAME OF SCHOOL	LOCATION	NO. OF YRS. COMPLETED	MAJOR AND DEGREE COMPLETED

College

NAME OF SCHOOL	LOCATION	NO. OF YRS. COMPLETED	MAJOR AND DEGREE COMPLETED

Bus. or Trade School

NAME OF SCHOOL	LOCATION	NO. OF YRS. COMPLETED	MAJOR AND DEGREE COMPLETED

Have you ever been convicted of a crime, which has not been annulled, expunged or sealed by a court?

YES
NO

(The existence of a criminal record does not constitute an automatic bar to employment. It will be considered only as it is related to the job in question.)

Nature of the offense(s)

Date of the offense

Month

Day

Year

Conviction Date

Month

Day

Year

Sentence Imposed

Type of Rehabilitation

Are there felony charges pending against you?

Yes
No

Explain

How did you hear about this employment opportunity?

DO YOU HAVE A DRIVER’S LICENSE?

Yes
No

What is your means of transportation to work?

Are you able to drive your vehicle to a jobsite if needed?

Yes
No

Driver’s license number

State of issue

Normal Operator
Commercial (CDL) “A” –OR- “B”
Chauffeur

Expiration date

Have you had any accidents during the past three years?

Yes
No

How many?

Please provide date(s), and describe:

Have you had any moving violations during the past three years?

Yes
No

How many?

Please provide date(s), and describe:

Please list two references other than relatives or previous employers.

Name

Position

Company

Address

Street Address City State ZIP Code

Address

Street Address City State ZIP Code

Phone

Email

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Military

HAVE YOU EVER BEEN IN THE ARMED FORCES?

Yes
No

Which branch?

ARE YOU NOW A MEMBER OF THE NATIONAL GUARD or RESERVE UNIT?

Yes
No

Specialty

Date Entered

Discharge Date

If other than Honorable Discharge, please explain

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Employer

Name of Supervisor

Address

Street Address City State ZIP Code

Employment Start Date

Employment End Date

Phone

Reason for leaving (be specific)

Starting Salary

Ending Salary

Your last job title

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

Employer

Name of Supervisor

Address

Street Address City State ZIP Code

Employment Start Date

Employment End Date

Phone

Reason for leaving (be specific)

Starting Salary

Ending Salary

Your last job title

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

Employer

Name of Supervisor

Address

Street Address City State ZIP Code

Employment Start Date

Employment End Date

Phone

Reason for leaving (be specific)

Starting Salary

Ending Salary

Your last job title

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

Employer

Name of Supervisor

Address

Street Address City State ZIP Code

Employment Start Date

Employment End Date

Phone

Reason for leaving (be specific)

Starting Salary

Ending Salary

Your last job title

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

May we contact your present employer?

Yes
No

Did you complete this application yourself?

Yes
No

If not, who did?

Phone

This field is for validation purposes and should be left unchanged.