Lemmons Trucking Inc. Application

Lemmons Trucking, Inc.

Employment Application
Date of Application

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name

First Name Middle NameLast Name Suffix
Contact Information

Mobile NumberOther Number
Email Address
example@example.com
Present Address
Complete Address
Previous Address if less than 3 years at current address
Complete Address
Position Applying For
Location You Are Applying For
Full Time or Part Time
Shift Preference
Availability for Employment

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Have you ever worked for our company before?
Have you applied to this company in the previous 12 months?
How did you learn the job opening?
If referred, please provide name
Educational Attainment

Education HIstory

Rows	Name and Address of Institution	Inclusive Dates(From/To)	Degree/Major
College
High School
Other

Work Experience

Please list your complete work history for the last 10 years beginning with your most recent job held.
May we contact your present employer?

Please indicate N/A if not applicable

Rows	(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Department
Supervisor and Position
Reasons for Leaving

Rows	(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Department
Supervisor and Position
Reasons for Leaving

Rows	(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Department
Supervisor and Position
Reasons for Leaving

Rows	(Start from most recent)
Name of Employer
Address
Telephone No.
Employment Dates
Position Held
Scope of Work
Department
Supervisor and Position
Reasons for Leaving

Special Qualifications/Skills
(ex. Typing, Steno, Driving, Computer/Software Skills, etc.)
Training / Seminar Attended
Name of Training and Date Attended

Do you hold a current commercial vehicle (CMV) operator's license or permit?

Please list all state(s) that have issued you a driver's license within the past 10 years:

Rows	License#	Expiration Date	Issuing State
Current
Previous
Previous

Please list all violations of motor vehicle laws or ordinances for which you were convicted or forfeited bond or collateral during the past 5 years:

Rows	Description of Violation
DATE
DATE
DATE

Have you ever had a denial, revocation, or suspension of any license, permit, or privilege to operate a motor vehicle in any state?

REFERENCES

Rows	Name	Position /Company	Relation	Contact No.	Known How Long
Reference 1
Reference 2
Reference 3

READ CAREFULLY BEFORE SIGNING:

In submitting this application for employment, I understand that the Company may investigate any and/or all information provided by myself or others during the hiring process. I fully understand that no one is guaranteed an interview or consideration beyond the application form.

Any offer of employment is contingent on passing a pre-employment drug screen. By signing this applicaiton, I understand that if I am offered employment, I will agree to submit to pre-employment drug screening required by this Company. A refusal to test will disqualify me from further consideration for employment, or reapplying in the future for any position with the Company. A positive test will disqualify me from further consideration; however, I may reapply after six (6) month for available openings which I am qualified.

My signature below certifies I filled out this application and that all information is true and correct and complete to the best of my knowledge and belief. I understand that providing false statements, answers, any misrepresentation, or any omission of relevant information will result in rejection of application, refusal of employment, or possible termination if discovered after date of hire.

I understand that my employment with the Company is on an "at will" (that is mutual consent) basis. Therefore, I agree that either I or the Company has the proper right to terminate my employment with or without cause at any time.
I have read & fully understand, and I agree to the above section
Electronic Signature

First Name Middle NameLast Name Suffix
Date

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

Lemmons Trucking, Inc.

Educational Attainment

Work Experience