Fidler Furniture - Job Application

DO YOU HAVE A VALID DRIVER'S LICENSE?

YESNO
DRIVER'S LICENSE NUMBER:
DRIVER'S LICENSE STATE OF ISSUE:
TYPE OF LICENCE:

OPERATORCOMMERCIAL (CDL)CHAUFFEUR
CHAUFFEUR EXP. DATE:
ANY DRIVING RESTRICTIONS?
WHAT IS YOUR MEANS OF TRANSPORTATION TO WORK?

My own vehicleBusFriendUber
HAVE YOU HAD ANY ACCIDENTS IN THE PAST THREE YEARS? IF YES, HOW MANY?
HAVE YOU HAD ANY MOVING VIOLATIONS IN THE LAST THREE YEARS? IF SO, HOW MANY?
Please list three references other than relatives or previous employers:
Name   First Name   Last Name
Phone:   Area Code   Phone Number
Name   First Name   Last Name
Phone:   Area Code   Phone Number
Name   First Name   Last Name
Phone:   Area Code   Phone Number
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to sumarize any additional information necessary to describe your full qualifications for the specific position for which you are applying:

HAVE YOU EVER BEEN IN THE ARMED FORCES?

YesNo
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?

YesNo
IF YES, WILL YOU NEED TO TAKE TIME OFF FOR SERVICE? PLEASE LIST FREQUENCY, DATES, TIMES.
Specialty Type here
Date Entered Date
Discharge Date Date
Most Recent Previous Employer Type here         Street Address   Address Line 2   City   State   Zip
Phone:   Area Code   Phone Number
SupervisorFirst Name   Last Name
Employment Dates -
From:     Date
To:   Date
Pay or Salary:
Start
Final
Last Job Title:
Reason for leaving (be specific):
Duties performed:
Previous Employer Type here         Street Address   Address Line 2   City   State   Zip
Phone:   Area Code   Phone Number
SupervisorFirst Name   Last Name
Employment Dates -
From:   Date
To:     Date
Pay or Salary:
Start
Final
Last Job Title:
Reason for leaving (be specific):
Duties performed:
Previous Employer Type here         Street Address   Address Line 2   City   State   Zip
Phone:   Area Code   Phone Number
SupervisorFirst Name   Last Name
Employment Dates -
From:     Date
To:   Date
Pay or Salary:
Start
Final
Last Job Title:
Reason for leaving (be specific):
Duties performed:
MAY WE CONTACT YOUR CURRENT EMPLOYER?
Please list two emergency contacts (1of2):
Name     First Name   Last Name
Phone   Area Code   Phone Number
Relationship:
Please list two emergency contacts (2of2):
Name First Name   Last Name
Phone   Area Code   Phone Number
Relationship:
PLEASE READ CAREFULLY:

APPLICATION FORM WAIVER:

In exchange for the consideration of my job application by Fidler Furniture Company (hereinafter called “the Company”), I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment or to confer any right to remain an employee of the company or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and the company may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise its benefits, policies, and procedures and such changes may include a reduction in benefits.

I authorize the 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 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.

I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be probationary for a period of ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

This Company 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 this Company depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.
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APPLICATION FOR EMPLOYMENT