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    Employment Application


    APPLICANT NOTICE:

    The following pre-employment procedures will be conducted upon acceptance of a contingent offer of employment:

    • Criminal background check

    • Valid Driver’s license

    • Verification of vehicle insurance

    • Verification of academic credentials, (if applicable)

    Fields marked with a RED asterisk * are REQUIRED FIELDS:

    APPLICANT INFORMATION
    * Full Name
    * Current Address
    * Previous Address
    * How long at current address?
    * City
    * State
    * Zip
    Home Phone
    Cell Phone
    * Email
    * SS#
    * Driver's License #
    * Issuing State:
    * Expiration:
    * Auto Insurance Company
    * Policy #
    * Exp. Date:
    * Position Applied For:
    * Have you ever applied for employment with Handz-On in the past?
    If yes, when?
    * Are you a citizen of the U.S.?
    If no, are you authorized to work in the U.S.?

    EDUCATION
    School Type
    School Name
    School City/State
    School Years Attended
    Graduated?
    Certification(s)

    School 2

    School Type
    School Name
    School City/State
    School Years Attended
    Graduated?
    Certification(s)

    School 3

    School Type
    School Name
    School City/State
    School Years Attended
    Graduated?
    Certification(s)

    REFERENCES

    Reference 1

    Full Name
    Relationship
    Company
    Phone
    Address

    Reference 2

    Full Name
    Relationship
    Company
    Phone
    Address

    Reference 3

    Full Name
    Relationship
    Company
    Phone
    Address

    PREVIOUS EMPLOYMENT
    Company
    Phone
    Address
    Supervisor
    Job Title
    Responsibilities
    Employment Dates: FROM: TO:
    Reason For Leaving
    May we contact employer?

    Previous Employer

    Company
    Phone
    Address
    Supervisor
    Job Title
    Responsibilities
    Employment Dates: FROM: TO:
    Reason For Leaving
    May we contact employer?

    Previous Employer

    Company
    Phone
    Address
    Supervisor
    Job Title
    Responsibilities
    Employment Dates: FROM: TO:
    Reason For Leaving
    May we contact employer?

    MILITARY SERVICE
    Branch
    FROM: TO:
    Rank of Discharge
    Type of Discharge
    If other than honorable, explain:

    DISCLAIMER AND SIGNATURE

    It is the policy of Handz-On, Inc. to afford equal opportunity to all employees and applicants for employment without regards to age, race, religion, color, sex, national origin, marital status, or pregnancy, and to afford equal opportunities to veterans and individuals with a disability, and any characteristics protected by Federal, State, or Local Law.

    I understand and acknowledge that any employment relationships with this organization is of and “AT WILL” nature, which means that the employee may resign at any time 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 verbal or written statements or by conduct unless the administrative director of Handz-On specifically acknowledges such change in writing.

    I certify that my answers are true and complete to the best of my knowledge.

    If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

    Please upload a resume (if you have one). Acceptable formats: TXT | PDF | DOC | DOCX
    *Digital Signature
    Date

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