Apply - Hickory Sealing and Striping, Inc.

Personal Information

First Name *

Middle

Last *

Email Address

Day Phone *

Evening Phone

Street Address *

Apartment, suite, etc

City *

State *

ZIP Code *

Have you lived at another address in the last 7 years?Yes

Please the list your last four addresses (up to 7 years)

(List most recent first)

Previous Addresses

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Position applying for: *0 / 30

Shift Desired0 / 30

Type of work desired *Full-TimePart-Time

Date available to start *

Education History

High School/Secondary School

Name of School *

School Address

City *

State/Province *

ZIP / Postal Code

Country

Highest Grade Completed *

Did you graduate? *YesNo

Grade (GPA)

Degree/Diploma/Certificate

Major Course of Study

Vocational/Technical School or College

Name of School

School Address

City

State/Province

ZIP / Postal Code

Country

Highest Grade Completed

Did you graduate?YesNo

Grade (GPA)

Degree/Diploma/Certificate

Major Course of Study

Certifications

Name of Organization

City

State/Province

Degree/Diploma/Certificate

Employment History

List most recent employer first

Company Name

May we contact?YesNo

Street Address

City

State

Supervisor/Manager

Your name when employed, if different from current

Job Titles and Duties

Reason for leaving

Presently Employed

Start Date

End Date

Starting Salary

USD

Ending Salary

USD

References

Please list three personal references who are not relatives.

Name

Phone

Address

General Questions

Have you ever applied for a job with this company in the past? *If yes, please give the date of application and the position for which you applied. Please state your name at the time, if different.YesNo

If hired, will you be able to work the scheduled days and hours required for the position for which your are applying? *If no, please explain.YesNo

Do you have any commitments to another employer that might affect your employment with our company? *If yes, please explain.YesNo

If hired, can you furnish proof that you are at least 18 years of age? *If no, please explain.YesNo

Have you ever been convicted of a crime other than traffic violation? *If yes, please explain. A "Yes" answer does not automatically disqualify you from employment. The nature and seriousness of the offense, as well as the position you are applying for will be considered.YesNo

Please read carefully and initial each paragraph before completing your application.

I have disclosed all information that is relevant and should be applicable to my candidacy for employment.

Certification of Information Provided *By my signature at the bottom of this form and initials placed below, I certify that the information provided in this employment application (and accompanying résumé, if any) is true and complete, and i understand that any false information or any significant omissions may disqualify me from further consideration for employment, and may be justification for my dismissal from employment, if discovered at a later date. I agree to notify the company immediately if I should be convicted of a crime while my application is pending, or during my employment, if hired.0 / 3

Release of Information *I authorize any person, school, current employer, past employer(s), and organizations named in this application (and accompanying résumé, if any) to provide the company or its designee with relevant information and opinion that may be useful to the company in making a hiring decision, and I release such persons and organizations from any legal liability in making such statements.0 / 3

Consent to Drug Test *A drug test will be required. A physical examination may also be required. I understand that any offer of employment may be withdrawn if I do not produce a negative drug test or if a condition is discovered for which no reasonable accommodation can be made.0 / 3

Confidentiality Agreement *I further understand that as a condition of employment I may be required to execute an Employee Agreement which includes provisions governing the confidentiality of information owned by or entrusted to Hickory Sealing and Striping and requiring the assignment to Hickory Sealing and Striping of rights in discoveries, inventions, improvements and expressions of ideas made by me during the course of my employment.0 / 3

Employment at Will Statement *I understand that neither this application, nor any offer of employment which results, creates, nor is intended to create, a contract of employment. I understand that, if hired, my employment is for no definite period of time and may be terminated at any time, with or without cause and with or without notice.0 / 3

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Join the Hickory Sealing and Striping Team

Job Application

Personal Information

Please the list your last four addresses (up to 7 years)

(List most recent first)

Education History

Employment History

References

Please list three personal references who are not relatives.

General Questions

Please read carefully and initial each paragraph before completing your application.

I have disclosed all information that is relevant and should be applicable to my candidacy for employment.