Application for Employment

Application for Employment
ALPHARETTA, GA
We are an Equal Opportunity Employer and is committed to excellence through diversity.
The application must be fully completed to be considered. Please complete each section, even if you attach a resume.
Personal Information
Name (Last, First, MI)
Address

Address

Street Address Line 2

CityState

Zip
Phone Number
Format: (000) 000-0000.
Are you under the age of 18?
Mobile Number
Format: (000) 000-0000.
Email Address
example@example.com
Are you legally eligible for employment in the United States and able to provide work authorization?
We are a drug free workplace. If selected for employment, are you willing to submit to a pre-employment drug screening test?
Position
Position You Are Applying for
Available Start Date

MonthDayYear
Date
Desired Pay
Employment Desired
Which days are you available to work?
Willing to work overtime?
Have you worked for us before? Yes
If yes, when?
How were you referred?

Other
Are you related to an employee of our Company?
If yes, provide name and relationship

Education

Rows	School Name	Location	Grade Completed (list highest)	Degree Received	Major

Military Status
Specialized Skills
Please list any profession job related certifications/licenses you hold:
Computer Skill Level
List specific software programs you have experience:
For Warehouse Applicants Only:
If yes, what kind?
If yes, what kind?
Professional References

List references who are familiar with your abilities, experience and character and whom you have known for at least 3 years. Please do not include relatives.

Rows	Name	Phone	Occupation/Title	Years Known

Employment History
List in sequence all employers, beginning with the most recent / present employer. Explain any gaps in employment in comments section on next page. If additional space is needed, please attach separate sheet(s
Employer #1
Name
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employment Type
Telephone
Format: (000) 000-0000.
City & State
Supervisor & Title
Job Title
Reason for Leaving
Summarize Job Duties
Employer #2
Name
Telephone
Format: (000) 000-0000.
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employment Type
City & State
Supervisor & Title
Job Title
Reason for Leaving
Summarize Job Duties
Employer #3
Name
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employment Type
Telephone
Format: (000) 000-0000.
City & State
Supervisor & Title
Job Title
Reason for Leaving
Summarize Job Duties
Summarize Job Duties
Please explain any gaps in employment
Drug Free Workplace
Drug and alcohol testing supports the Company’s efforts to maintain a drug-free workplace. All drug and alcohol testing will be conducted in conformance with applicable law.

Testing for the presence of illegal drugs is required of all individuals to whom a conditional offer of employment has been made.

For the purpose of being further considered for employment, I hereby agree to submit to a drug and/or alcohol test.

I understand that favorable test results will not necessarily guarantee that I will be employed by the Company.

If I am accepted for employment, I agree to take drug and/or alcohol tests whenever requested by a Company representative, and I understand that the taking of such tests is a condition of my continued employment.

Applicants who refuse to cooperate in a drug test or who test is confirmed positive will not be hired. Applicants turned down due to test results, may reapply following a waiting period of 1 year.
Do you agree to the terms and conditions set forth above regarding drug and/or alcohol testing?
Signature Disclaimer
I authorize Wiedmann Bros., and its employees and agents, to communicate with and make inquiries of my former employers. I

understand that these inquiries may relate to my job performance, the position(s) which I held, the dates of my employment, the

reasons for the termination of my employment and other job-related inquiries.

I hereby certify that all statements made in this application are true and complete to the best of my knowledge. I understand that any

misrepresentation or omission of facts in this application may be considered cause for rejection of my application or termination of

employment if discovered after being hired.

I further certify that I may lawfully be employed in this country, and if employed, will provide required documentation to verify

identity and employment eligibility in the required time period.

I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and

salary, be terminated at any time without any previous notice.

I hereby acknowledge that I have read the above statements and understand them.
Signature
Date

MonthDayYear
Date
Please Upload Your Resume & Cover Letter

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Application for Employment

ALPHARETTA, GA

Personal Information

Position

Specialized Skills

For Warehouse Applicants Only:

Professional References

Employment History

Drug Free Workplace

Signature Disclaimer