Employment Application

Applicant Information

First Name *

Last Name *

Date

Email *

Phone *

Alt. Phone *

S.S. Number (Optional)

Education

Highschool

Diploma/Degree Type *

Did You Graduate? *

Yes

College 1

Diploma/Degree Type *

Did You Graduate? *

Yes

College 2

Diploma/Degree Type *

Did You Graduate? *

Yes

Other

Diploma/Degree Type *

Did You Graduate? *

Yes

Work Experience

(Please list most recent experience first.)

Position / Title

Company Name and City where located.

Start Date

End Date

List of Responsibilities

Name of Immediate Supervisor

Phone Number of Immediate Supervisor

Reason for leaving.

Position / Title

Company Name and City where located.

Start Date

End Date

List of Responsibilities

Name of Immediate Supervisor

Phone Number of Immediate Supervisor

Reason for leaving.

Position / Title

Company Name and City where located.

Start Date

End Date

Position / Title

Company Name and City where located.

List of Responsibilities

Name of Immediate Supervisor

Phone Number of Immediate Supervisor

Reason for leaving.

Are you currently employed? *

Yes

If yes, can we contact your current employer? *

Yes

Drivers

(Complete this section if you wish to be considered for “Driver” designation in the position for which you are applying)

Do you have a valid driver’s license?

Yes

Driver's license #

Driver's license State

License Type

CDL

Have you had any other driver’s licenses in the past five years?

Yes

State Issued

License #

Have you ever had your driver’s license suspended or revoked?

Yes

Have you ever driven a box truck or cube van?

Yes

If yes, please explain. *

Tell about any accidents you’ve been involved in as a driver in the past five years.

Initial here if you give Cayas Canopies permission to obtain a copy of your driving record from the DMV?

List all moving violation convictions you have received in the past five years.

Date

Violation

Penalty

Date

Violation

Penalty

Date

Violation

Penalty

Date

Violation

Penalty

Schedule

Check all days of the week that you are Not available to work.

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Schedule Notes

What things would prevent you from working weekends or in the evening, working over the time you were scheduled to work, or accepting last minute changes to the work schedule? *

Questionnaire

(Applications that are not filled out completely will not be considered.)

How many hours per week would you prefer to work? *

Minimum

How many hours per week would you prefer to work? *

Maximum

What date are you available to start work? *

What wage would you expect to earn for this position? *

$/Hour

How did you find out about the job opening at Cayas Canopies & Rental? *

In the past, what has been your biggest problem on the job? How did you solve it? *

How many scheduled days of work did you miss during the past year? *

How many of those days were Mondays or Fridays? *

When was the last time you were warned, reprimanded, or fired for violation of a safety rule? *

Month/Year

Describe what happened.

When was the last time you were warned, reprimanded, or fired for violation of company policy? *

Month/Year

Describe what happened.

When was the last time you were involved in an accident while working that resulted in personal injury or property damage? *

Month/Year

Describe what happened.

Tell about the most recent conflict you’ve had with another person at work and how it was resolved? *

Who was the person with whom you had the conflict?

Co-worker

Management

Customer

Supplier

Please list any other related skills and experience that may aid you in the performance of your duties:

What else would you like to tell us about yourself that may aid you in the performance of your duties?

References

(List two professional and one personal reference.)

Name 1 *

Name 1

First Name

Last Name

Phone *

Relationship *

# of Years Known *

Name 2 *

Name 2

First Name

Last Name

Phone *

Relationship *

# of Years Known *

Name 3 *

Name 3

First Name

Last Name

Phone *

Relationship *

# of Years Known *

List any current Cayas Canopies employees that you know

Waiver & Release Section

Are you willing to submit to a drug screening? *

Yes

If Yes, Please Initial *

Signature *

Clear

By signing above you, the applicant, understand and agree to the following terms:

* Cayas Canopies regards false, misleading, or omitted information on this application (and any supporting documentation) as immediate grounds for reprimand or dismissal.

*Cayas Canopies is an employment-at-will employer and can terminate any employee for any or no reason.

*This document is not an offer of employment.

*Cayas Canopies may check references and you, the applicant, free anyone from being liable for releasing such information to Cayas Canopies.

*Cayas Canopies may give references on terminated employees and be held harmless for giving out truthful information.

*Cayas Canopies may require you, the applicant, to submit to a drug screening any time prior to or during employment.

*Cayas Canopies may release medical information on employees involved in job-related accidents.

*Cayas Canopies may change wages and benefits at any time.

*Cayas Canopies may refer employment-related disputes to binding arbitration.

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Employment Application

Applicant Information

Education

Work Experience

Drivers

Schedule

Questionnaire

References

Waiver & Release Section

About Cayas Canopies

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Employment Application

Applicant Information

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Education

Work Experience

Drivers

Schedule

Questionnaire

References

Waiver & Release Section