J. P. Weaver, Inc.

J. P. Weaver, Inc.

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.
Date*

MonthDayYear
MM/DD/YYYY
Name*

FirstLast
Date of Birth:*

DayMonthYear
Social Security Number:*
No Dashs or Spaces
Phone Number:*

Area Code
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Driver's License

License NumberExpiration Date
ID Number
Driver's License / Photo Identification
Position Applied For: *
Pay Expected*
Have you ever applied for employment with us?*

YesNo
If Yes, Give Date
MM/DD/YYYY
Have you ever been employed with us before?*

YesNo
If Yes, Give Date
MM/DD/YYY
Are you currently employed?*

YesNo
May we contact your present employer?*

YesNo
Do you have a valid driver's license?*

YesNo
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? *Proof of citizenship or immigration status will be required upon employment.*

YesNo
Have you been convicted of a felony? (Conviction will not necessarily disqualify applicant from employment.)*

YesNo
If yes, please explain:
Are you currently on "lay-off" status and subject to recall?*

YesNo
Are you 18 years or old?*

YesNo
Education

School*

	Name and Address of School	No. of Years Completed	Did You Graduate?	Degree or Diploma
High School
College
Business/ Trade/ Technical

Work Experience

Please give accurate, complete full-time and part-time employment record. Start with your present employer.
Company Name:*
Telephone*
(XXX) XXX- XXXX
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employed From:*

MonthDayYear
Date started.
Employed To:*

MonthDayYear
Date ended.
Name of Supervisor:*
Weekly Pay:*
State Job Title and Describe Your Work*
Reason for Leaving*
We may contact the employers listed above unless you indicate those you do not want us to contact.
Employers Name & Reason Not to Contact.
Company Name:
Telephone
(XXX) XXX- XXXX
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employed From:

MonthDayYear
Date started.
Employed To:

MonthDayYear
Date ended.
Name of Supervisor:
Weekly Pay:
State Job Title and Describe Your Work
Reason for Leaving
Company Name:
Telephone
(XXX) XXX- XXXX
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employed From:

MonthDayYear
Date started.
Employed To:

MonthDayYear
Date ended.
Name of Supervisor:
Weekly Pay:
State Job Title and Describe Your Work
Reason for Leaving

Personal / Professional References

Do not include family members or past supervisors.

	Name	Phone Number	Best Time to Call	Occupation
1.)
2.)
3.)

APPLICANT'S STATEMENT
I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in the application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

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 furher understood that this "at will" employment relationship may not be changeed by any written document or by conduct unless such change is specifically ackowledge in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Signature of Applicant*

Clear
Date:*
DD/MM/YYYY
Should be Empty: