• DW Richards Sons Employment Application

    Please complete the employment application below and our Human Resourse Department will be in contact with you.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Are you 18 years of age or older?*
  • Are you prevented from lawfully becoming employed in this country because of Visa or immigration status?
  • Employment desired:
  • Can you work nights?
  • Do you have a Driver's Licence?
  • Type of licence you hold:
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  • EDUCATION

  • Did you graduate?
  • Did you graduate?
  • FORMER EMPLOYERS

    List 2 former employers
  • Format: (000) 000-0000.
  • May we contact your supervisor?
  • Format: (000) 000-0000.
  • May we contact your supervisor?
  • REFERENCES

    Please list 2 personal references. Do not include family members or relatives.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Medical History

  • Do you have any impairments, mental or medical that would interfere with your ability to perform the position for which you are applying?
  • Do you have any lifting limitations or restrictions that would affect your work performance?
  • Have you had any back injuries?
  • Are you color blind?
  • Have you collected Worker's Compensation?
  • Please read, sign and date.

     I cerftify that the answers given are true and complete to the best of my knowledge.  I authorize investagation of all statements contained in this Application of Employment as may be necessary in arriving at an employment decision.

    In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.  I understand, also, that I am required to abide in all the rules and regulations of the employer.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: