Lonsdale Packaging Employment Application Form

Lonsdale Packaging

Application for Employment. Equal Opportunity Employer.
Name*

First NameLast Name
Date of Application*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date*

MonthDayYear
Phone Number*
Format: (000) 000-0000.
Employment Desired
Position
Date You Can Start
Salary Desired
Are you Employed Currently?
If so, May We Contact Your Present Employer?
Have You Applied to This Company Before?
When?

MonthDayYear
Date
Education History
Grammar School
High School
College
Former Employers (List Below Last Four Employers, Starting With the Last One First)
Date: Month & Year | Name & Address of Employer | Salary | Position | Reason for Leaving
References

Give Below the Names of Three Persons Not Related To You, Whom You Have Known At Least One Year, and a Phone Number to Contact Them to Verify Them as a Reference.
Reference 1
Reference 2
Reference 3
Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal."

"I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent informaiton they may have, personal or otherwise, and release the company from all liability for any damage that may result from the utilization of such information."

"I also understand and agree that no representative of the company has any authority to enter any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

"This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
Signature*
Date*

MonthDayYear
Date
Should be Empty:

Lonsdale Packaging

Employment Desired

Education History