City Ice Company
APPLICATION FOR EMPLOYMENT |
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| POSITION APPLYING FOR: |
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DATE: |
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| HOW DID YOU LEARN ABOUT US? |
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| LAST NAME: |
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| FIRST NAME: |
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| MIDDLE NAME: |
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| ADDRESS: |
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| CITY: |
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| TELEPHONE (Home): |
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| CELL PHONE: |
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| EMAIL ADDRESS: |
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| SOCIAL SECURITY NUMBER:
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NAME OF NEAREST
LIVING RELATIVE: |
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| ADDRESS: |
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| CITY: |
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| RELATIVE PHONE: |
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RELATION
TO YOU: |
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| DO YOU HAVE A VALID
VIRGINIA’S DRIVER’S LISCENCE?: |
YES |
NO |
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IF UNDER THE AGE OF 18,
CAN YOU PROVIDE PROOF
OR YOUR ELIGIBILITY TO
WORK?: |
YES |
NO |
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| HAVE YOU EVER FILED AN
APPLICATION WITH US BEFORE?: |
YES |
NO |
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| IF YES, Date? |
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HAVE YOU EVER BEEN
EMPLOYED WITH US
BEFORE?: |
YES |
NO |
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| IF YES, GIVE DATES: |
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ARE YOU CURRENTLY
EMPLOYED?: |
YES |
NO |
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MAY WE CONTACT
YOUR EMPLOYER?: |
YES |
NO |
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ON WHAT DATE WOULD
YOU BE AVAILABLE FOR
WORK?: |
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ARE YOU ABLE TO WORK
(check All that apply):  |
FULL TIME |
PART TIME |
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EVENINGS |
WEEKENDS |
WILL YOU BE WILLING
TO WORK OVERTIME?: |
YES |
NO |
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AT WHAT RATE OF PAY
WOULD YOU EXPECT TO
START AT?: |
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HAVE YOU EVER BEEN
CONVICTED OF A FELONY
WITH IN THE LAST SEVEN YEARS?:
(Convictions will not necessarily disqualify
an applicant from employment) |
YES |
NO |
| IF YES, PLEASE EXPLAIN: |
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| WORK HISTORY |
START WITH YOUR PRESENT OR LAST
JOB. INCLUDE ANY JOB-RELATED MILITARY SERVICE
ASSIGNMENTS AND VOLUNTEER ACTIVITIES. YOU
MAY EXCLUDE ORGANIZATIONS WHICH INDICATE RACE,
COLOR, RELIGION, NATIONAL ORIGIN, DISSABILITIES
OR OTHER PROTECTED STATUS. |
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| EDUCATION |
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| OTHER QUALIFICATIONS |
SUMMERIZE SPECIAL JOB-RELATED
SKILLS AND QUALIFICATIONS ACQUIRED
FROM EMPLOYMENT OR OTHER EXPERENCES. |
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STATE ANY ADDITIONAL
INFORMATION YOU FEEL MAY BE HELPFUL
TO US IN CONSIDERING YOUR APPLICATION. |
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| APPLICANT’S
STATEMENT |
| I CERTIFY THAT THE
ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE TO
THE BEST OF MY KNOWELEDGE. I AUTHORIZE CITY
ICE COMPANY TO INVESTIGATE All STATEMENTS CONTAINED
IN THIS APPLICATION FOR EMPLOYMENT AS MAY BE
NECESSARY IN ARRIVING AT AN EMPLOYMENT DECISION.
THIS APPLICATION FOR EMPLOYMENT SHALL BE CONSIDERED
ACTIVE FOR A PERIOD OF TIME NOT TO EXCEED 30
DAYS. ANY APPLICANT WISHING TO BE CONSIDERED
FOR EMPLOYMENT BEYOND THIS TIME PERIOD SHOULD
INQUIRE AS TO WHETHER OR NOT THE APPLICANTIONS
ARE BEING ACCEPTED AT THAT TIME.
I HEARBY UNDERSTAND AND ACKNOWLEDGE THAT, UNLESS
OTHERWISE DEFINED BY APPLICABLE LAW, ANY EMPLOYMENT
RELATIONSHIP WITH THIS ORGANIZATION IS OF AN
“AT WILL” NATURE, WHICH MEANS THAT
THE EMPLOYEE MAY RESIGN AT ANYTIME AND THE EMPLOYER
MAY DISCHARGE THE EMPLOYEE AT ANY TIME WITH
OR WITHOUT CAUSE. IT IS FURTHER UNDERSTOOD
THAT THIS “AT WILL” EMPLOYMENT RELATIONSHIP
MAY NOT BE CHANGED BY ANY WRITTEN DOCUMENT OR
BY CONDUCT UNLESS SUCH CHANGE IS SPECIFICALLY
ACKNOWLEDGED IN WRITING BY AN AUTHORIZED EXECUTIVE
OF THIS ORGANIZATION.
IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT
FALSE AND MISLEADING INFORMATION GIVEN IN MY
APPLICATION OR INTERVIEW(S) MAY RESULT IN DISCHARGE. I
UNDERSTAND, ALSO, THAT I AM REQUIRED TO ABIDE
BY ALL RULES AND REGULATIONS OF THE EMPLOYER.
SHOULD I BE HIRED, I UNDERSTAND THAT I WILL
BE SUBJECT TO RANDOM DRUG AND ALCOHOL TESTING. I
WILL ALSO BE SUBJECT TO A DRUG AND ALCOHOL TEST
FOLLOWING ANY ACCIDENT WHICH MAY OCCUR IN WHICH
I AM INVOLVED. |
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Click here To
Agree with the above and submit your application
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