APPLICATION FOR EMPLOYMENT
Durastone Corporation
is a drug-free workplace and an equal employment opportunity affirmative action employer
.
LAST NAME
FIRST NAME
MIDDLE NAME
ADDRESS
PHONE NUMBER
CITY
STATE
ZIP
E-MAIL ADDRESS
PERSONAL
POSITION APPLIED FOR
DESIRED SALARY
HOW WERE YOU REFERRED TO US?
ARE YOU APPLYING FOR:
FULL TIME
PART TIME
SEASONAL/TEMPORARY
DO YOU HAVE LEGAL RIGHT TO WORK IN THE UNITED STATES?
YES
NO
IF NO, WHEN?
DATE AVAILABLE TO BEGIN WORK
ARE YOU ABLE TO TRAVEL?
YES
NO
HAVE YOU BEEN CONVICTED OF A FELONY IN THE PAST FIVE YEARS?
YES
NO
IF YES, EXPLAIN.
NOTE: A yes response does not automatically disqualify an applicant for employment.
EDUCATION
HIGH SCHOOL
CITY/STATE
GRADUATE
YES
NO
COLLEGE
CITY/STATE
GRADUATE
YES
NO
OTHER TRAINING
PREVIOUS EXPERIENCE
FROM
TO
IMMEDIATE SUPERVISOR
LAST SALARY
TITLE
EMPLOYER
PHONE NUMBER
ADDRES
DUTIES
REASON FOR LEAVING
FROM
TO
IMMEDIATE SUPERVISOR
LAST SALARY
TITLE
EMPLOYER
PHONE NUMBER
ADDRES
DUTIES
REASON FOR LEAVING
MAY WE CONTACT YOUR PRESENT EMPLOYER?
YES
NO
STATEMENT
ADDITIONAL INFORMATION YOU MAY THINK HELPFUL TO YOUR CONSIDERATION FOR EMPLOYMENT
READ THIS SECTION PRIOR TO PROVIDING INITIAL BELOW
I, the underinitialed, agree that this organization may make any lawful inquiry that it considers necessary to determine my eligibility
for employment. I authorize this organization to seek and obtain from my present and former employers, schools and personal
references, information relating to my qualifications for employment. I release this organization and all persons and entities
furnishing such information to this organization form any liability arising from dissemination or publication of such information.I
understand that any job offer with this organization is conditioned upon my ability to establish employment eligibility under the
Immigration Reform and Control Act of 1986.AGREEMENT FOR DRUG AND ALCOHOL TESTING. I freely and voluntarily agree to
submit to a drug test as part of my application for employment. I understand that either refusal to submit to the test or failure to meet
the standards established by this organization for this test may disqualify me for employment. All information provided in this
application and any accompanying resume is true and complete. I agree that any false or misleading representation or material
omission may disqualify me from consideration for employment and may result in discharge, regardless of when discovered.I have read
and understand the foregoing and I agree unconditionally to the foregoing.
INITIAL
DATE
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