D&D Trailers Employment Application

Employment Application

D&D is an equal opportunity employer. Applicants will be considered regardless of race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services, and employment is available to all individuals. Applicants requiring accommodations to the application and/or interview process should contact the Human Resource Representative.

Each question should be answered completely and accurately.

No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.

Full Name*

First NameLast Name

Phone Number

Address*

Street Address

CityState / Province

Postal / Zip CodeCountry

E-mail*

Position applying for*

Wage expectations*

Referral source*

Are you over the age of 18?*

YESNO

Are you eligible to work in the United States?*

YESNO

Do you have a valid driver's license?*

YESNO

Are you currently employed?*

YESNO

Date available for work*

MonthDayYear

Are you available to work?*

Full timePart timeShift workTemporary

D&D operates six days a week and we will require a flexible schedule. Please indicate the days and times that you ARE available to work.*

Have you applied here before?*

YESNO

If yes, give date:

Have you ever been employed by D&D?*

YESNO

If yes, give date:

Are you related to a current D&D employee?*

YesNo

If Yes, give name(s) of relative(s) and relationship(s):

Have you been convicted of a felony/misdemeanor (other than traffic violations)?*

YESNO

If so, provide the location, date and result/outcome for each conviction:*

EDUCATION

Highest level of education completed:*

Please complete the appropriate sections*

	Name & Location of School	Did You Graduate?	Year Graduated
GED / High School
Trade School
College
Graduate

WORK HISTORY

Please list your most recent employers, list the most recent first

1. Employer

Employer's Name (Most current)*

Address & location of business*

Your title*

May we contact this employer?*

YESNO

Supervisor's name*

First and Last Name

Phone Number

Start date*

MonthDayYear

End date

MonthDayYear

Wages START:*

Salary or Hourly*

Wages END:*

Salary or Hourly*

Work performed:*

Reason for leaving*

2. Employer

Employer's Name (Second most recent)

Address & location of business

Your title

May we contact this employer?

YESNO

Supervisor's name

First and Last Name

Phone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

Have you ever been asked to resign or been discharged from any position?

YesNo

If Yes, please explain:

List job-related accomplishments, projects, and awards. (Exclude information that would reveal race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status.)

List any additional information you would like us to consider:

REFERENCES

List at least 2 professional references, (business or work, not relatives) that you have known for at least one year. List at least one previous supervisor.

1. Full Name*

First NameLast Name

Company*

Phone Number

Years acquainted*

Relationship*

2. Full Name

First NameLast Name

Company

Phone Number

Years acquainted

Relationship

AUTHORIZATION

Please read the following statements carefully and add your signature in the space provided.

If employed by D&D, I understand and agree to the following:

This application is not an offer, promise or contract of employment, either expressed or implied. I understand that anyemployment or offer of employment arising out of this Employment Application will be subject to satisfactory verification of all job qualifications including but not limited to credentials, licenses, professional designations and employment history.

I authorize D&D or any division or subsidiary, to investigate my references (including communicating with my former employers) and to independently investigate my character, as well as any court and employment records. Under the Fair Credit Reporting Act, a routine investigation may be conducted to provide information concerning my character, general reputation, personal characteristics and credit history. I have the right to request the source of this information and the nature and scope of this investigation, if once is conducted. I hereby release D&D from any and all liability and responsibility
arising out of the release, request, receipt or use of such reports, or information and credit reports.

I also understand that if employed by D&D or any division or subsidiary, employment is for no fixed period of time and may be terminated by me or D&D or any division or subsidiary at any time and for no reason with or without notice specifically prohibited by law. No oral representation to the contrary has been made to me, and further understand that no employee of D&D or any division or subsidiary is authorized to make any such representation.

I hereby certify that the information contained in this Employment Application is true and accurate. I understand that is I become employed; any misrepresentation of facts on this Employment Application may result in summary dismissal.

By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree

You must agree to accept the terms of the document in order to submit an application.

Type signature*

Signature

Date*

MonthDayYear

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