APPLICATION FOR EMPLOYMENT

Transcription

1 APPLICATION FOR EMPLOYMENT PLEASE PRINT: Date of Application Name Last First Middle Address Street City State Zip Code Length of Residence Previous Address Street City State Zip Code Length of Residence Number Social Security Number Area Code Driver s License Number Class State Position Applying For Referral Source: Advertisement Employee Employment Agency Walk-in Do you know anyone working at Capitol Group? Yes No If yes, whom? Are you legally eligible for employment in this country?... Yes No (Proof of U.S. citizenship or immigration status will be required upon employment.) Date available for work Type of employment desired: Full Time Part Time Are you on lay-off and subject to recall?... Yes No Will you relocate if job requires it? Yes No Will you travel if job requires it? Yes No Are you able to meet the attendance requirements of the position?... Yes No Will you work overtime if required?... Yes No Have you ever been bonded?... Yes No Capitol Group Inc is an Equal Opportunity. Capitol Group Inc does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant s consideration for employment on a basis prohibited by local, state or federal law.

2 Employment History List your last four (4) employers, assignments or volunteer activities, starting with the most recent, including military experience.

3 Educational Background School No. Years Complete Degree/ Diploma GPA/Class Rank Major Minor References List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you. Reference Name Number Years Known READ THIS CAREFULLY I hereby consent to providing a sample of my urine and/or breath for alcohol and drug screening for the purpose of pre-employment testing and in accordance with Capitol Group, Inc. ( Capitol ) policy as established in the Capitol Handbook. The purpose of this analysis is to determine the absence or presence of controlled substances. I hereby release and hold harmless Capitol, its employees and agents from any liability what so ever arising out of or connected with the testing of my specimen. I authorize the lab and/or the Medical Review Officer and/or Breath Alcohol Technician retained by Capitol to release test result information to Capitol. Capitol may obtain information on an employee through investigation and/or the use of Consumer Reports, Investigative Consumer Reports and Consumer Credit Reports for the purpose of making employment related decisions, including hiring, retaining and promotion. Any report(s) may involve verifying written or oral information on the employment application, resumé, or otherwise. Such information, as permitted by law, may relate to the character, general reputation, personal characteristics, lifestyle, work habits, work performance and experience, reasons for discipline in or termination from any current or prior employment, history of earnings, criminal convictions, driving history, credit worthiness, credit standing or credit capacity and other related matters. Capitol may contact past employer, educational institution, law enforcement agency, credit bureau, collection agency, private business, military branch including the national personnel records center, personal reference and all other person or entities concerning matters listed above. Furthermore, I release all said persons and entities from collection or providing information from any and all liability for any damage that may result from complying with requests made in accordance with this policy. If hired or promoted, any false, misleading or omitted information on the employment application, resumé, and/ or interview(s) may result in disciplinary action and up to and including termination. NO CONTRACTS OR EMPLOYMENT I recognize that this application is not an offer to enter into a contract or a contract of employment. I further recognize and agree that if I am employed by the Company, such employment will not result in a contract for employment and that the Company may terminate my employment at any time, for any reason. This application is current for only 60 days. At the conclusion of this time, if I have not heard from the and still wish to be considered for employment, it will be necessary to fill out a new application. Signature of Applicant Date

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