Premier Products, Inc. - Employment Application Form 

PLEASE COMPLETE ALL OF THE INFORMATION REQUESTED IN THE APPLICATION FORM

Complete the following application and click “Submit” once you have verified that you have answered every question and that the information entered is correct.

 

OFFICE USE ONLY:

Date received:

Reviewed by:

 

 

 

 

PLEASE COMPLETE THE ENTIRE FORM.

DATE

Name

 

Last

First

Middle

Maiden

Present address

 

Number

Street

City

State

Zip

How long at current address?

 

Telephone E-mail Address

Are you under age 18   YES  NO, if “YES”, can you provide proof of your eligibility to work?   YES   N0

Are you currently authorized to work in the United States?   YES   NO. 

Proof of eligibility will be required if hired.

 

 

Days/hours available to work

Position applied for (1)

Any

YES

Thu

and wage desired   (2)

Mon

Fri

(Be specific)

 

Tue

Sat

 

 

Wed

Sun

How many hours can you work weekly?

Employment desired          FULL-TIME ONLY         PART-TIME ONLY         FULL- OR PART-TIME

When are you available to start work?

 

 

TYPE OF SCHOOL

NAME OF SCHOOL

LOCATION
(Complete mailing address)

NUMBER OF YEARS COMPLETED

MAJOR & DEGREE

High School Graduated From

College or University

Bus. or Trade School

Professional School

 

Have you ever been convicted of a crime?     No    Yes    

(A conviction record will not necessarily disqualify you from employment).

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation.

 

 

DO YOU HAVE A DRIVER’S LICENSE?            Yes                No

What is your means of transportation to work?

Driver’s license
 State of issue           Operator   Commercial (CDL)   Chauffeur

Expiration date

Have you had any accidents during the past three years?   Yes   No

How many?

Have you had any moving violations during the past three years?   Yes   No

How Many?

 

OFFICE POSITIONS ONLY

 

 

Typing            Yes                                            10-key                Yes                                Word                      Yes

                        No                                                                          No                             Processing                No

Personal       Yes        PC

Computer      No          Mac

Other Skills

Please list two references other than relatives.

Name

Name

Position

Position

Company

Company

Address

Address

               

               

Telephone 

Telephone 

Please use this space to elaborate on any background, experience, or qualifications that you believe should be considered in evaluating your qualifications for employment.  You may include hobbies, volunteer experience and any other activities you believe relevant.  Please omit any information that would disclose your race, gender, age, marital status, ethnic origin, religious or political affiliations, or disability.

 

 

MILITARY EXPERIENCE

 

 

HAVE YOU EVER BEEN IN THE ARMED FORCES?                     Yes                No

ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?                          Yes                No

Specialty Date Entered  Discharge Date

 

Work Experience

Please list your work experience beginning with your most recent job held.
If you were self-employed, give firm name. 

 

 

Name of Employer

Name of last supervisor

Employment Dates

Pay or salary

Address

 

 

City, State, Zip Code

From

From

Start

Phone Number

To

To

Final

 

Your Last Job Title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

 

Name of Employer

Name of last supervisor

Employment Dates

Pay or salary

Address

 

 

City, State, Zip Code

From

From

Start

Phone Number

To

To

Final

 

Your Last Job Title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present employer?         Yes                No

Did you complete this application yourself    Yes                No   If not, who did?

PLEASE READ CAREFULLY

 

APPLICATION FORM WAIVER

As indication that you have read and understood each of the following sentences, please check the box at the end of the form.

In exchange for the consideration of my job application by Premier Products, Inc., (hereinafter called “the Company”), I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Premier Products, Inc., or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Owner/Managing Member of the Company.   Both the undersigned and Premier Products, Inc. may end the employment relationship at any time, without specified notice or reason.   If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.   I hereby give the Company permission to contact schools, all previous employers (unless otherwise indicated), references and others and hereby release the Company from any liability as a result of such contact.

I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics and mode of living.   Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be probationary for a period of ninety (90) days and further that at any time during the probationary period or thereafter, my employment relationship with the Company is terminable at will for any reason by either party.

 

I have read and understand the Application Form Waiver

 

Date of Applicant’s Submission:

 

Premier Products, Inc. is an equal employment opportunity employer.  We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age or disability.  We assure you that your opportunity for employment with Premier Products, Inc. depends solely on your qualifications. 

Thank you for completing this application form and for your interest in our business. Please click the "Submit" button below to complete the application process.