ACCEL EMPLOYMENT APPLICATION REV4-2024

“People ask if I’m worried about investing in employees who might leave. My answer is always the same: I’m far more concerned about the ones who stay if we never develop them. At Accel, we believe our responsibility is to help people become the very best version of themselves. If we do that well, our customers win, our team wins, and our company wins.” -Shon Vodila, President of Accel Pest & Termite
EMPLOYMENT APPLICATION
Date Completed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
This Is A Drug-Free Work Place Offering Equal Employment Opportunities. Applications are received and employees are hired without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, childbirth or related medical conditions (including lactation), age, genetic information, ethnic or national origin, disability, veteran's status, military status or service, citizenship status, marital status, AIDS/HIV status, lawful use of a lawful product when not at work, sickle cell or hemoglobin C trait, or any other characteristic protected by federal, state, or local law.
Applicant Information
Name
Full Name
Address

Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone
Format: (000) 000-0000.
Preferred Method Of Contact
Tell Us About Yourself
You must answer every question on this application. If a question does not apply, put “N/A.”
What position are you applying for?
What are your pay expectations?
When can you start work? (Date)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
How were you referred to us? (If you were referred by a person, please provide the name)
Have you completed an application here before?
If yes, date/location
Have you been employed here before?
If yes, date/location
Do you have steady transportation to work?
Are you now, or do you expect to be, engaged in any other business or employment while working here?
If yes, please explain
Are you legally eligible to work in the United States?
Please list any vehicles you have driven as part of your work experience, including the type of vehicle, purpose of driving (i.e. deliveries, transportation) and any relevant certifications or licenses held.
Education

Education

Rows	Years Completed	Degree Received	Name Of School	Did you Graduate? (Yes/No)
High School or GED
Trade, Business, or Correspondence
College
Graduate School

Licenses / Certificates
Do you hold a Valid Driver's License that is not currently suspended or revoked? (For positions requiring driving)
If Yes, in what State?
Have you been convicted of any moving violations in the last 5 years or have any pending moving violations? (For positions requiring driving)
Have you ever had any professional license or certificate suspended or revoked?
If Yes, to either of the above 2 questions please list dates and explanation for each.

Employment History / Work Gaps
In the past 7 years have you had any employment gaps over 6 months?
If Yes, Please Explain
Employer
City
State
Phone
Format: (000) 000-0000.
Supervisor’s Name
Your Position
Dates Employed (MM/YYYY - MM/YYYY)
(MM/YYYY - MM/YYYY)
Reason For Separation
Employer
City
State
Phone
Format: (000) 000-0000.
Supervisor’s Name
Your Position
Dates Employed (MM/YYYY - MM/YYYY)
(MM/YYYY - MM/YYYY)
Reason For Separation
Employer
City
State
Phone
Format: (000) 000-0000.
Supervisor’s Name
Your Position
Dates Employed (MM/YYYY - MM/YYYY)
(MM/YYYY - MM/YYYY)
Reason For Separation
Employer
City
State
Phone
Format: (000) 000-0000.
Supervisor’s Name
Your Position
Dates Employed (MM/YYYY - MM/YYYY)
(MM/YYYY - MM/YYYY)
Reason For Separation
Employer
City
State
Phone
Format: (000) 000-0000.
Supervisor’s Name
Your Position
Dates Employed (MM/YYYY - MM/YYYY)
(MM/YYYY - MM/YYYY)
Reason For Separation
Employer
City
State
Phone
Format: (000) 000-0000.
Supervisor’s Name
Your Position
Dates Employed (MM/YYYY - MM/YYYY)
(MM/YYYY - MM/YYYY)
Reason For Separation

Applicant Agreement
For the purpose of this agreement, the organization that has provided you with this application is referred to as "the company," "this company," or "you" in the following paragraphs:

The facts set forth above in my application for employment are true and complete. I understand that false statements or omission of information on this application (even if discovered after employment) or any other employment form may lead to dismissal or denial of employment. I understand that any background check or consumer report will be conducted only after a conditional offer of employment and only with my separate written authorization. You are authorized to administer pre-employment tests. A criminal record or sentence is not an automatic disqualification for employment. I agree to submit to any drug or alcohol testing prior to or after employment.

I authorize the use of any information in this application to verify my statements, and I authorize past employers and references to answer questions concerning my previous employment record.

I understand that if my application is accepted and if I am hired, employment with this company at all times is employment "at will." It is further understood that this "at will" relationship may not be changed by any written document, verbal statements, or by conduct unless an authorized executive of this company specifically acknowledges such change. I further understand that my "at will" employment may be terminated at any time by this company or myself and includes no guarantee, contract or promise of employment for any specific length of time. I understand that the first 90 days of employment is a new-hire introductory period. Submission of this application does not imply that I will be hired.

I have read, understand, and by my signature consent to these statements:
Signature of Applicant
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

EMPLOYMENT APPLICATION

Applicant Information

Tell Us About Yourself

Education

Licenses / Certificates

Employment History / Work Gaps

Applicant Agreement