Application for Employment

Application for Employment

Pre-Employment Questionnaire | Equal Opportunity Employer
Personal Information
Name*

First NameLast Name
SSN*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Referred by
Employment Desired
Position*
Date you can start*
YesNo
YesNo
YesNo
YesNo
When was your last date of application?

MonthDayYear
Date
General Information
Areas of special study/work
Special Training
Special Skills
YesNo
Former Employers
Name of Employer*
Address of Former Employer

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Former Employer*
Please enter a valid phone number.Format: (000) 000-0000.
Start Date Month, Day & Year*

MonthDayYear
Date
End Date Month, Day & Year*

MonthDayYear
Date
Pay Rate
Former Position*
Reason for Leaving
Additional Employment?
Name of Employer*
Address of Former Employer

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Former Employer*
Please enter a valid phone number.Format: (000) 000-0000.
Start Date Month, Day & Year*

MonthDayYear
Date
End Date Month, Day & Year*

MonthDayYear
Date
Pay Rate
Former Position*
Reason for Leaving
References
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Name
Number of years known
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 the investigation of all statements contained herein and the references and employers listed above to provide you with any and all information concerning my previous employment and any pertinent information 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 into any agreement for employment for any specified 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."
Date*

MonthDayYear
Date
Signature*

Clear
Ordering of MVR Release Form
I have applied for employment with Guettler Brothers Equipment, LLC / Guettler Brothers Construction, LLC in a position that requires me to operate an automobile or truck. As a condition for my application to be considered, I understand and agree to allow the ordering of my Motor Vehicle Driving Record (MVR). I understand that if my driving record contains certain types of violations or problems as reviewed by the Company, I shall not be considered further for a car or truck driver position.

I hereby authorize any representatives of the Company or an authorized insurance professional retained by the Company to order such records and to provide the results to the Company. Furthermore, I release the Company and any person affiliated with this action and any such institution or person conducting the screening from liability.
Insured's Name: Guettler Brothers Equipment, LLC
Driver's Name*

First NameLast Name
Driver's Date of Birth*

MonthDayYear
Date
Driver's License Number*
Driver's License State*
Date*

MonthDayYear
Date
Driver's Signature*

Clear
Application Fee
Our company requires applicants to pay an application fee of $35.00 upon acceptance of an offer for employment. The application fee is refundable, dependent on the ability to adhere to our company policies and a successful 30-day probationary period, where the applicant is to remain employed on the 31st day of employment. The application fee is charged for applications that are or are able to be credibly considered for the position, but it does not guarantee the applicant a position. The fee will not be charged to any applicants where the position does not exist or for a position that has already been filled.

The application fee of $35.00 can be made payable by cash or check at our facility.

By signing below, I am stating that I understand and agree to the above terms.
Signature*

Clear
Name*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

Application for Employment

Personal Information

Employment Desired

General Information

Former Employers

References

Authorization

Ordering of MVR Release Form

Application Fee