APPLICATION FOR EMPLOYMENT

 
A * indicates required fields.
P
E
R
S
O
N
A
L
Last Name*
 First*
 Middle*
Date*
Street Address*
Home Telephone*
City*
 State*
 Zip*
Business Telephone*
Have you ever applied for employment with us?*
Yes No
Social Security # *
If yes, Month and Year:  

Location:

Position Desired*
Operations/Dispatch Billing/Payroll Safety/Recruiting
Logs Truck Wash Entry Level/General Clerical
Pay Expected*
Are you available to work full time?*
Yes No		 If not, what hours can you work?
Will you work overtime if asked?*
Yes No
Are you legally eligible for employment in the United States?*
When can you begin work?*
 
Other special training or skills (languages, machine operations, computers, etc.)?*

 
E
D
U
C
A
T
I
O
N
School Name and Location
of School		 Course of Study No. of
Years
Completed		 Did You
Graduate?		 Degree or Diploma
Graduate Yes
No
College Yes
No
Business/
Trade/Tech.		 Yes
No
High School Yes
No
Elementary Yes
No

 
Membership in Professional or Civic Organizations*
(Exclude those which may disclose your race, color, religion or national origin)

 

 
EMPLOYMENT Please give us accurate, complete full-time and part-time employment record. Start with your present or most recent employer.

 
1
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
State Job Title and Describe Your Work:
Reason for Leaving:

 
2
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
State Job Title and Describe Your Work:
Reason for Leaving:

 
3
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
State Job Title and Describe Your Work:
Reason for Leaving:

 
4
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
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.
DO NOT CONTACT
Employee Number(s):
 Reason for Leaving:

 
MILITARY
Did you serve in the
U.S. Armed Forces?*		 Yes No
If "yes," in what Branch?
Describe any training received relevant to the position for which you are applying.*

 
Prospective employees will receive consideration without discrimination because of race,
creed, color, sex, age, national origin, handicap or veteran status.
Provide dates you attended school:
Elementary
From To
High School
From To
College
From To
Other (give name and address)
Are you a U.S. Citizen?*
Yes   No
What was your previous address?
How long at present address?
Years:
How long at previous address?
Years:
Have you ever been bonded?*   Yes   No

If "yes," with what employers?
Are you over 18 years of age? *  Yes   No

If not, employment is subject to verification of age.
Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses
which have been annulled, expunged or sealed by a court?*
Yes   No    If "yes," describe in full:
State names of relatives and friends working for us, other than your spouse:

 
I understand that John Christner Trucking is a drug free work place, and at the companies discretion, random drug testing will be required.

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.

I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.

If you decide to engage in investigative consumer reporting agency on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.

I agree that my employment and compensation can be terminated, with or without cause, and with or without notice. At any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its President, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

By submitting this application online you agree to the above said terms and conditions.