APPLICATION FOR EMPLOYMENT

References

(Non- Family)
Name
Phone Number
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Name
Phone Number
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Name
Phone Number
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Indicate any foreign languages you can speak, read and/or write
SPEAK
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EMPLOYMENT HISTORY

(Most recent first)
Company Name
Phone Number
Address

Address

Street Address Line 2

CityState

Zip
Name of Supervisor
Dates Employed (Month & Year)
FROM
TO
Job Title and Duties
Weekly Pay
START
LAST
Reason for leaving
Company Name
Phone Number
Address

Address

Street Address Line 2

CityState

Zip
Name of Supervisor
Dates Employed (Month & Year)
FROM
TO
Job Title and Duties
Weekly Pay
START
LAST
Reason for leaving
Company Name
Phone Number
Address

Address

Street Address Line 2

CityState

Zip
Name of Supervisor
Dates Employed (Month & Year)
FROM
TO
Job Title and Duties
Weekly Pay
START
LAST
Reason for leaving
List any other experience, skills, or qualifications that apply to this position, such as community or civic activities, leadership positions, machines and equipment you can operate, typing skills, software proficiencies, etc. You may attach a separate sheet if necessary

Please read and understand before signing your application:

I certify that the information given by me in this application and in any interviews is true and complete in all respects, and understand any falsification or omission shall be sufficient cause for dismissal from or refusal of employment. I authorize DTC (the Company) toinvestigate my work experience, business activities, education, criminal background, driving record, credit history, general reputation, character, qualifications, and/or suitability for employment. I hereby release from all liability and responsibility the Company and all persons, institutions, employers, organizations, and/or agencies providing information pursuant to this authorization and investigation. If employed I agree to conform to the policies, rules, and regulations of the Company. I understand any offer of employment may be conditioned on the completion of a post-offer, pre-employment drug screen. If a drug screen is required, I consent to the release of my drug test results to the Company.

I agree that the Company may deduct from my paycheck any amounts necessary to reimburse DTC for the cost of any unreturned,broken or damaged equipment and any unpaid advances to my wages that are outstanding.

I understand that if I am employed, I may terminate my employment at any time without notice or cause, and the Company has the same right. I understand employment with the Company is not for a definite term or period of time and is terminable at-will. Nothing contained in this application creates a contract between the Company and myself for employment or any other benefit. No one other than the General Manager or President of the Board of Directors has authority to make assurances to the contrary, and then such assurances must be in writing and signed by the authorized person.

The company does not refer to applications previously submitted. You must re-apply each time there is an opening if you wish to be considered.
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PERSONAL DATA

EDUCATION

Beginning with the most recent, list all colleges, vocational, trade and military service schools attended.

References

EMPLOYMENT HISTORY