Employment Application

EMPLOYMENT APPLICATION
Please provide complete answers to all questions. Incomplete answers will only slow or stall the application process.
Applicant Name*

First NameMiddle Name / Initial (optional)Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
What position are you applying for?*
What days are you available to work?*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
What shift are you available to work?*

1st2nd3rd
If needed, are you available to work overtime?*

YesNo
If hired, when can you start working?
Are you a citizen of the United States?*

YesNo
If No, are you authorized to work in the United States?*

YesNo
What documentation can you provide as proof of citizenship or legal status?*
Social Security Card, Birth Certificate, Valid I.D., etc.
Have you ever worked for Laudick Trucking, Inc. in the past?

YesNo
If Yes, when?
Have you ever been convicted of a felony or misdemeanor?*

YesNo
If Yes, please provide dates, city, county, nature of offense, jail time, and any fines received.
Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, the surrounding circumstances, and the relevance of the offense to the position(s) applied for may, however, be considered.
Employment History
Start with your current or most recent position, including any military experience, and work backwards (you can upload supportive attachments if necessary by scrolling to the bottom of this form). You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information.
Employer 1
Company Name*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Is this your current employer?*

YesNo
Position Held*
Responsibilities
Start Date*

MonthDayYear
Ending Date*

MonthDayYear
If current employer, please select today's date.
Supervisor
Reason for leaving?*
Employer 2
Company Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Position Held
Responsibilities
Start Date

MonthDayYear
Ending Date

MonthDayYear
Supervisor
Reason for leaving?
Employer 3
Company Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Position Held
Responsibilities
Start Date

MonthDayYear
Ending Date

MonthDayYear
Supervisor
Reason for leaving?
Education
High School (or equivalent)
School Name
School Location
City, State
Did you graduate?

YesNo
If No, years completed?
College
College Name
College Location
City, State
Did you graduate?

YesNo
Highest Degree Awarded
If No, years completed?
Other Qualifications
Please list any other qualifications or skills that you believe should be considered.
References

Please list (3) professional references not related to you. If you don’t have (3) professional references, then list personal, unrelated references.
Name
Company
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Title / Relationship
Number of Years Known
Reference 2
Name
Company
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Title / Relationship
Number of Years Known
Reference 3
Name
Company
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Title / Relationship
Number of Years Known
Upload Files
Click to Browse Files and upload your resume, cover letter, and/or any supporting documents.

Only pdf, doc, docx, and txt files are supported.
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Disclosure Statement and Agreement
Signature*
Should be Empty:

Employment History

Employer 1

Employer 2

Employer 3

Education

References

Reference 2

Reference 3

Upload Files

Disclosure Statement and Agreement