Employment Application
Please complete the entire application.
Employer Information
Employer Name: Prosperity Trucking LLC.
Address: 14110 Ursuline Road
City/State/ZIP Code: Gulfport, Mississippi 39503
Phone Number: 228-669-0946
It is the policy of Prosperity Trucking LLC. to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability, or veteran status.
Applicant Information
Applicant Full Name:
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years at This Address:
Primary Phone Number:
Secondary Phone Number:
Social Security Number:
Driver's License (State/Number):
Emergency Contact
Who should be contacted if you are involved in an emergency?
Contact Name:
Relationship:
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number:
Mobile Phone Number:
Job Position Applied For:
Full or Part Time?
Salary Desired: $
Who referred you to our company?
If you are offered employment, when would you be available to begin work?
If hired, are you able to submit proof that you are legally eligible for employment in the United States?
Yes
No
Applicant's Skills
Enter the number of years of experience, and circle the number that corresponds to your ability for each particular skill. (One represents poor ability, while five represents exceptional ability.)
Applicant Employment History
List your current or most recent employment first. Please list all jobs (including self-employment and military service) that you have held, beginning with the most recent, and list and explain any gaps in employment. If additional space is needed, continue on the back page of this application.
Employer Name:
Supervisor Name:
Address:
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Next
City/State/ZIP Code:
Job Duties:
Reason for Leaving:
Dates of Employment (Month/Year):
Employer Name:
Supervisor Name:
Address:
City/State/ZIP Code:
Job Duties:
Reason for Leaving:
Dates of Employment (Month/Year):
Employer Name:
Supervisor Name:
Address:
City/State/ZIP Code:
Job Duties:
Reason for Leaving:
Dates of Employment (Month/Year):
Applicant's Education and Training
College/University Name and Address:
Did you receive a degree?
Yes
No
If yes, degree(s) received:
High School/GED Name and Address:
Did you receive a degree?
Yes
No
Other Training (graduate, technical, vocational):
Please indicate any current professional licenses or certifications that you hold:
Awards, Honors, Special Achievements:
Military Service
Yes
No
Branch:
References
List any two non-relatives who would be willing to provide a reference for you.
Name:
Address:
City/State/ZIP Code:
Phone Number:
Relationship:
Name:
Address:
City/State/ZIP Code:
Phone Number:
Relationship:
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Next
Certification
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for the rejection of my application or, if employment commences, immediate termination.
I authorize Prosperity Trucking LLC. to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.
If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Owner, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Prosperity Trucking LLC., except in a specific written contract of employment signed on behalf of the organization by its Owner, has the power to alter or vary the voluntary nature of the employment relationship.
I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.
Applicant's Signature
Date
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Month
-
Day
Year
Date
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