SJ Tank Services | General Application

General Employment Application
Applicant Name
Date of Application

MonthDayYear
Date
In compliance with Federal and State equal opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, non-job-related disability, or any other protected group status.

To Be Read and Signed by Applicant

I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted. I understand that I have the right to:
- Review information provided by previous employers
- Have errors in the information corrected by previous employers and for those previous employers to resend the corrected information to the prospective employer
- Have a rebuttal statement attached to the alleged erroneous information if the previous employer(s) and I cannot agree on the accuracy of the information.
Signature

Clear
Date

MonthDayYear
Date
Last Name
First Name
Middle
Social Security #
Current Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
How long?
Previous Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long?
Email Address
example@example.com
Do you have the legal right to work in the United States?
Date

MonthDayYear
Date
Can you provide proof of age?
Are you currently employed?
If not, how long since leaving last job?
How did you hear about us?
If employee referral, name
Employment History

Please list employers in reverse order starting with the most recent. Add another sheet if necessary. List complete mailing address, street number, city, state, and zip code.
Employment #1
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Contact Person
Date From

MonthDayYear
Date
Date To

MonthDayYear
Date
Position
Salary/Wage
Reason for Leaving
Employment #2
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Contact Person
Date From

MonthDayYear
Date
Date To

MonthDayYear
Date
Postion
Salary/Wage
Reason for Leaving
Employment #3
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Fax Number
Contact Person
Date From

MonthDayYear
Date
Date To

MonthDayYear
Date
Postion
Salary/Wage
Reason for Leaving
List special courses/training/certifications, etc. that will help you in this position
List any other experiences that may help you in your work for this company
Education
Select the highest grade completed:

12345678
High School

1234
College

1234
Name of last school attended
City, State
Personal References
Reference #1
Name
Address
Phone Number
Relationship
Email Address
example@example.com
Reference #2
Name
Address
Phone Number
Relationship
Email Address
example@example.com
Reference #3
Name
Address
Phone Number
Relationship
Email Address
example@example.com
I authorize you to make such investigations and inquiries of my personal, employment, and/or medical history and other related matters as may be necessary in arriving at a decision. I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in termination. I understand, also, that I am required to abide by all rules and regulations of the Company.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Applicant Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Current Address

Previous Address

Employment History

Employment #1

Employment #2

Employment #3

Education

Personal References

Reference #1

Reference #2

Reference #3