Corrugated Replacements, Inc.
Employment Application
Full Name
*
First Name
Last Name
PERSONAL
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position Applied for
EDUCATION
Did you graduate from high school?
*
YES
NO
Year of Graduation
*
Dates attended From:
*
-
Month
-
Day
Year
Date
To:
*
-
Month
-
Day
Year
Date
School name & Address
*
Did you attend college?
YES
NO
Major or Degree
Did you graduate?
YES
NO
Dates Attended From:
-
Month
-
Day
Year
Date
To:
-
Month
-
Day
Year
Date
College name & address
Did you attend a business/trade/technical school?
YES
NO
Major or Degree
Did you graduate
YES
NO
Dates Attended. From:
-
Month
-
Day
Year
Date
To:
-
Month
-
Day
Year
Date
School name & address
EMPLOYMENT
Begin with last place employed.
Company
*
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor's Name
*
Job Title and Description of Work
*
Reason for Leaving
*
Company Name
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor's Name
Job Title and Description of Work
Reason for Leaving
Company Name
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor's Name
Job Title and Description of Work
Reason for Leaving
MILITARY SERVICE
(If applicable)
Branch of Service
Date From
-
Month
-
Day
Year
Date
Date to
-
Month
-
Day
Year
Date
APPLICANT'S SIGNATURE
Please read and understand this statement befoe signing your application.
The information I have provided in this Application for Employment is true, correct and complete. False, incomplete or misrepresented information of any kind, will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment. I authorize the employer to contact and obtain information about me from previous employers, educational institutions and “references” I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, a related employment resume or a personal interview. To assist in the processing of my Application, I waive all rights and claims I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose. This application will expire in 30 days. After that date, unless otherwise notified, I understand that my status as an applicant will end. I may re-apply for employment in the future by completing a new application. This application is not an employment agreement. If I accept an offer of employment I understand the employer may terminate my employment at any time, with our without cause and without prior notice, unless required by law. I understand that no one, other than an executive officer of the employer, has authority to enter into any employment agreement with terms contrary to the foregoing and then only in writing signed by such officer.
I fully understand and accept all terms and conditions in the above statement.
Date
*
-
Month
-
Day
Year
Date
Signature
*
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