Britton Industries | Application Form

Name *

Date *

Email Address *

Phone Number

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Permanent Address if different from present address:

Desired Employment

Referral Source

Position applying for:

What days and hours are you available for work?

If applying for temporary work, during what period of time will you be available?

From

Are you available for work on nights and weekends?.

YesNo

Would you be available to work overtime, if necessary?

YesNo

If hired, on what date can you start work?

PERSONAL INFORMATION

Have you ever applied to work for Britton Industries?

YesNo

If yes, when?

Do you have any friends or relatives working for Britton Industries?

YesNo

If hired, would you have a reliable means of transportation to and from work?

YesNo

Are you at least 18 years of old? (Note: If under 18, hire is subject to verification that you are of legal minimum legal age.)

YesNo

Do you have the legal right to work in the United States? (Note: Proof of identity and legal authority to work in the United States is a condition of employment.)

YesNo

Have you ever been convicted of a crime other than a traffic violation?

YesNo

If yes, please state the nature of the crime(s), when and where convicted and disposition of the case: (Note: A conviction will not automatically disqualify you for employment. Each case will be individually considered based on specific facts.)

Are you currently employed?

YesNo

If so, may we contact your current employer?

YesNo

Education

School

Address

Number of Years Completed

Did you graduate?

YesNo

Degree or Diploma

High School

School

Address

Number of Years Completed

Did you graduate?

YesNo

Degree or Diploma

College/University

School

Address

Number of Years Completed

Did you graduate?

YesNo

Degree or Diploma

Vocational/Business

School

Address

Number of Years Completed

Did you graduate?

YesNo

Degree or Diploma

Other

School

Address

Number of Years Completed

Did you graduate?

YesNo

Degree or Diploma

Employment History

Please list all present and past employment starting with your most recent employer (last ten [10] years is sufficient). You must complete this section even if attaching a resume. If additional pages are needed, please attach.

Name of Employer:

Address:

Type of Business

Telephone:

Supervisors Name:

Dates of Employment (From to):

Starting Pay:

Ending Pay:

May we contact this employer?.

YesNo

Reason for Leaving:

Employment History

Name of Employer:

Address:

Type of Business

Telephone:

Supervisors Name:

Dates of Employment (From to):

Starting Pay:

Ending Pay:

May we contact this employer?.

YesNo

Reason for Leaving:

Employment History

Name of Employer:

Address:

Type of Business

Telephone:

Supervisors Name:

Dates of Employment (From to):

Starting Pay:

Ending Pay:

May we contact this employer?.

YesNo

Reason for Leaving:

Employment History

Name of Employer:

Address:

Type of Business

Telephone:

Supervisors Name:

Dates of Employment (From to):

Starting Pay:

Ending Pay:

May we contact this employer?.

YesNo

Reason for Leaving:

ReferencesPlease list below three persons not related to you, who have knowledge of work performance within the last three (3) years:

Name

Occupation

Address

Telephone

Number of Years Acquainted:

ReferencesPlease list below three persons not related to you, who have knowledge of work performance within the last three (3) years:

Name

Occupation

Address

Telephone

Number of Years Acquainted:

ReferencesPlease list below three persons not related to you, who have knowledge of work performance within the last three (3) years:

Name

Occupation

Address

Telephone

Number of Years Acquainted:

Acknowledgments

Please read carefully, initial each paragraph, and sign below. *

I hereby certify that the information contained in this application is true and correct to the best of my knowledge. I futher certify that I, the undersigned applicant, have personally completed this application. I understand that any misrepresentation, falsification or omission of information on this application or any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery.I hereby authorize the Company to thoroughly investigate the information on my application, my references, work record, education and other matters related to my suitability for employment and, futher, authorize the references I have listed to disclose to the Company all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons or entities from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures.The Company adheres to a policy of AT-WILL employment which means that each employee and the Company each retain the right to terminate the employment relationship and that the Company retains the right to modify an employee’s position or compensation at any time, with or without cause or notice. No one other than the President has the authority to make any binding promise or enter into any agreement inconsistent with Company’s at-will policy and any such agreement must be in writing and signed by both the employee and the President of the Company to be effective.As a condition of employment, all individuals offered employment are required to submit to a pre-employment drug test.

Date

Signature *

I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically. Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.

Employment Application

Are you applying for: (Please check Yes or No)

Are you available for work on nights and weekends?.

Would you be available to work overtime, if necessary?

Have you ever applied to work for Britton Industries?

Do you have any friends or relatives working for Britton Industries?

If hired, would you have a reliable means of transportation to and from work?

Are you at least 18 years of old? (Note: If under 18, hire is subject to verification that you are of legal minimum legal age.)

Do you have the legal right to work in the United States? (Note: Proof of identity and legal authority to work in the United States is a condition of employment.)

Have you ever been convicted of a crime other than a traffic violation?

Are you currently employed?

If so, may we contact your current employer?

Did you graduate?

Did you graduate?

Did you graduate?

Did you graduate?

Did you graduate?

May we contact this employer?.

May we contact this employer?.

May we contact this employer?.

May we contact this employer?.

Please read carefully, initial each paragraph, and sign below. *

Signature *

location hours

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let's stay connected

Employment Application

Are you applying for: (Please check Yes or No)

Are you available for work on nights and weekends?.

Would you be available to work overtime, if necessary?

Have you ever applied to work for Britton Industries?

Do you have any friends or relatives working for Britton Industries?

If hired, would you have a reliable means of transportation to and from work?

Are you at least 18 years of old? (Note: If under 18, hire is subject to verification that you are of legal minimum legal age.)

Do you have the legal right to work in the United States? (Note: Proof of identity and legal authority to work in the United States is a condition of employment.)

Have you ever been convicted of a crime other than a traffic violation?

Are you currently employed?

If so, may we contact your current employer?

Did you graduate?

Did you graduate?

Did you graduate?

Did you graduate?

Did you graduate?

May we contact this employer?.

May we contact this employer?.

May we contact this employer?.

May we contact this employer?.

Please read carefully, initial each paragraph, and sign below. *

Signature *

location hours

get in touch

let's stay connected

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