APPLY

APPLICATION FOR EMPLOYMENT

Position Applying for:
Name:
E-mail:
Current Address:
How Long at Current Address?:
Previous Address:
How Long at Previous Address?:
Home Phone:
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Cell Phone:
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Are any of your relatives presently employed with the company?:
If 'Yes', who?:
Have you ever applied for a position with the company before?:
Have you ever been employed by the company before?:
How were you refered?:
If you are under the age of 18, state your age:
If you are under the age of 18, can you supply working papers?:
Only U.S. citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment, provide genuine documentation establishing your identity and eligibility to be legally employed in the United States?:
Have you ever been discharged from any employment or asked to resign?:
If YES, please explain:
AVAILABLE WORK SCHEDULE
Availability:
If less than 40 hours a week, please explain the hours and days available to work:
Salary/Wage Desired
ATTENDANCE AND PUNCTUALITY INFORMATION
Consistent attendance and punctuality are essential requirements of every job with this company. Is there anything, which would interfere with your regular attendance and punctuality if you were offered a job with the company? If YES, explain below:

BEGIN WITH YOUR MOST RECENT EMPLOYMENT (1) AND CONTINUE WITH ALL PAST EMPLOYMENT (ATTACH ADDITIONAL SHEET IF NECESSARY)

1
Name of Company:(1)
Start Date:(1)
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End Date:(1)
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Phone:(1)
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Address:(1)
May we contact this employer?:(1)
Type of Business:(1)
Job Title:(1)
Describe Your Job Duties:(1)
Ending Salary/Wages:(1)
Name & Title of Supervisor(1)
Reason(s) for Leaving:(1)
2
Name of Company:(2)
Start Date:(2)
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End Date:(2)
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Phone:(2)
-
Address:(2)
May we contact this employer?:(2)
Type of Business:(2)
Job Title:(2)
Describe Your Job Duties:(2)
Ending Salary/Wages:(2)
Name & Title of Supervisor(2)
Reason(s) for Leaving:(2)
3
Name of Company:(3)
Start Date:(3)
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End Date:(3)
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Phone:(3)
-
Address:(3)
May we contact this employer?:(3)
Type of Business:(3)
Job Title:(3)
Describe Your Job Duties:(3)
Ending Salary/Wages:(3)
Name & Title of Supervisor(3)
Reason(s) for Leaving:(3)
High School
High School:
High School Address:
Last Year Attended:
Graduated?:
College
College:
College Address:
Years Attended College:
Graduated College?:
Degree:
Graduate School
Grad School:
Grad School Address:
Years Attended Grad School:
Graduated Grad School?:
Graduate Degree:
Business/Trade School
Business/Trade School:
Business/Trade School Address:
Years Attended:
Graduated Business/Trade School?
Focus:
Reference 1
Reference(1) Name:
Reference(1) E-mail:
Reference(1) Home Phone:
-
Reference(1) Business Phone:
-
Reference(1) Employer:
Reference(1) Job Title:
Reference 2
Reference(2) Name:
Reference(2) E-mail:
Reference(2) Home Phone:
-
Reference(2) Business Phone:
-
Reference(2) Employer:
Reference(2) Job Title:
Reference 3
Reference(3) Name:
Reference(3) E-mail:
Reference(3) Home Phone:
-
Reference(3) Business Phone:
-
Reference(3) Employer:
Reference(3) Job Title:

I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE, I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACT ON THIS EMPLOYMENT APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) MAY RESULT IN MY NOT BEING CONSIDERD FOR EMPLOYMENT, AND IF NOT DISCOVERED BY MYERS WATER TRANSFER UNTIL AFTER MY BECOMING EMPLOYED, IS GROUNDS FOR, AND MAY RESULT IN, MY IMMEDIATE TERMINATION.

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State or Local law.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written documentation or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.

If hired, I agree to abide by all of the company rules and regulations. I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment. I understand that the Company and all Plan Administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. No representative or agent of the company has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the President or to make any agreement contrary to the foregoing.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.*
Electronic Signature:
Date:
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Upload Resume (Max: 10MB):