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Tri-Lakes Services, Inc.
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Application for Employment
Application for Employment
APPLICATION FOR EMPLOYMENT
(
*
Marked Fields Are Required )
NOTICE:
Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap, or veteran status.
Date
*
Job Title
*
Position Desired
*
Management
Clerical
Civil
Electrical
Equipment Operator
General Laborer
HPC- Fire Watch/Confined Space Attendant
Insulation
Mechanical
Paint
Pipe fitter
Scaffold
Welder
Other
Other
Please select one or multiple fields as they apply.
Personal
Full Name
*
Please enter your full legal name that appears on your Social Security Card. Including full middle name.
First Name
*
Middle Name
*
Last Name
*
Address
*
Street Address Line 1
*
Street Address Line 2
City
*
State
*
Zip Code
*
Home Phone
*
Cellphone
Email Address
*
Social Security Number
*
Have you ever applied for employment with us?
*
YES
NO
If you select "No" please disregard the date and location.
Date Last Applied
Location Last Applied
License Class
CDL
NON-CDL
Pay Expected
Apart from absence for religious observance, are you available for full-time work?
*
YES
NO
If not, what hours can you work?
Will you work overtime if asked?
*
YES
NO
Are you legally eligible for employment in the United States?
YES
NO
When will you be available to begin work?
*
Will you have to give a notice?
*
YES
NO
Other special training or skills (languages, machine operation, etc.)
Education
Name and Location of College
Course of Study
Years Completed
Did You Graduate?
YES
NO
Business/Trade/ Technical School
Course of Study
Years Completed
Did You Graduate?
YES
NO
Name and Location of High School
Course of Study
Years Completed
Did You Graduate?
YES
NO
Name and Location of Elementary School
Course of Study
Years Completed
Did You Graduate?
YES
NO
Organizations
(Exclude those which may disclose your race, color, religion, or national origin)
Membership in Professional or Civic Organizations
Employment History
Have you been employed prior to applying for Tri-Lakes Services?
*
YES
NO
Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.
1. Company Name
Telephone
Address
City
State
Zip Code
Start Date (MM/DD/YYYY)
End Date (MM/DD/YYYY)
Name of Supervisor
Supervisor Job Title
Weekly Pay: Start
Weekly Pay: End
State Job Title and Describe Your Work
Reason for Leaving
2. Company Name
Telephone
Address
City
State
Zip Code
Start Date (MM/DD/YYYY)
End Date (MM/DD/YYYY)
Name of Supervisor
Supervisor Job Title
Weekly Pay: Start
Weekly Pay: End
State Job Title and Describe Your Work
Reason for Leaving
3. Company Name
Telephone
Address
City
State
Zip Code
Start Date (MM/DD/YYYY)
End Date (MM/DD/YYYY)
Name of Supervisor
Supervisor Job Title
Weekly Pay: Start
Weekly Pay: End
State Job Title and Describe Your Work
Reason for Leaving
4. Company Name
Telephone
Address
City
State
Zip Code
Start Date (MM/DD/YYYY)
End Date (MM/DD/YYYY)
Name of Supervisor
Supervisor Job Title
Weekly Pay: Start
Weekly Pay: End
State Job Title and Describe Your Work
Reason for Leaving
Do Not Contact
We may contact the employers listed above unless you indicate those you do not want us to contact.
Do Not Contact Phone #1
Reason
Do Not Contact Phone #2
Reason
Military Service
Did you serve in the U.S. Armed Forces
*
Yes
No
Describe any training received relevant to the position for which you are applying.
Additional Information
NOTICE:
The information requested is needed for a legally permissible reason, including, without limitation, national security considerations, legitimate occupational qualification or business necessity. The Civil Rights Act or 1964 prohibits discrimination in employment because of race, color, religion, sex, or national origin. Federal law also prohibits discrimination based on age, citizenship and disability. The laws of most States also prohibit some or all of the above types of discrimination as well as some additional types such as discrimination based upon ancestry, marital status and sexual preference.
Are you a U.S. Citizen?
*
Yes
No
How many years at present address?
How many years at previous address?
Are you over 18 years of age?
*
Yes
No
If not, employment is subject to verification of age.
Criminal Record
*
Yes
No
Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court?
If "Yes," describe in full.
State names of relatives and friends working for us, other than your spouse.
Signature
Your signature will be obtained during the interview process. By submitting this form, you agree to the following:
The information provided in this Application for Employment is true, correct, and complete. If you employ me, any misstatement or omission of fact on this application may result in my dismissal.
I understand that acceptance of an offer of employment creates no obligation upon you, the employer, to continue to employ me in the future.
Human Verification
If you are human, leave this field blank.
Submit Application
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