NAFECO Employment Application Form

PLEASE PRINT ALL INFORMATION
REQUESTED EXCEPT SIGNATURE


APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS


PLEASE FILL OUT COMPLETELY

DATE:

Full Name:
Last Name: First Name: Middle Name: Maiden Name:

Present Address:
Street Number: Street Name: City: State: Zip Code:

How long: Social Security Number: - -

Home Phone: Cell Phone: Email:

If under 18, please list age:

Position applied for (1):
and salary desired (2):
(Be specific)
Days / hours available to work:
No Preference:     Thur.
Mon.     Fri.
Tue.     Sat.
Wed.     Sun.







How many hours can you work weekly? Can you work nights?

Employment Desired: FULL-TIME ONLY PART-TIME ONLY FULL- OR PART-TIME

When available for work?


TYPE OF SCHOOL NAME OF SCHOOL LOCATION
(Complete mailing address)
# OF YRS
COMPLETED
MAJOR & DEGREE
High School
         
College
         
Bus. or Trade School
         
Professional School
         


HAVE YOU EVER BEEN CONVICTED OF A CRIME?

NO

YES

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Note: The existence of a conviction will not necessarily preclude you from employment; the nature of the crime and its relationship to the position applied for, the degree of rehabilitation of the applicant and the time elapsed since the crime or release from confinement will all be considered.



DO YOU HAVE A DRIVER'S LICENSE?

NO

YES

What is your means of transportation to work?

Driver's License:
Number: State of Issue: Expiration Date: Operator Commercial (CDL) Chauffeur

If potentially driving a company vehicle, NAFECO will need to obtain a copy of your Motor Vehicle Driving record. I agree to this NO YES  
Have you had any accidents during the past three years? NO YES How many?
Have you had any moving violations during the past three years? NO YES How many?


OFFICE SKILLS
Microsoft Excel: NO YES Microsoft Word: NO YES

Other Skills:



Please list two references other than relatives or previous employers

Name:
Position:
Company:
Address:
Phone:
Name:
Position:
Company:
Address:
Phone:









An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.



MILITARY
HAVE YOU EVER BEEN IN THE ARMED FORCES? NO YES
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD? NO YES
Specialty: Date Entered: Discharge Date:


Work Experience
Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.
Name of Employer:
Address:
Address (2):
City:
State: Zip Code:
Phone:
Name of Last Supervisor:
Employment Dates:
From: To:
Pay / Salary:
Start: Final:
Your Last Job Title:
Reason for leaving (be specific):








List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.


Name of Employer:
Address:
Address (2):
City:
State: Zip Code:
Phone:
Name of Last Supervisor:
Employment Dates:
From: To:
Pay / Salary:
Start: Final:
Your Last Job Title:
Reason for leaving (be specific):








List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.


Name of Employer:
Address:
Address (2):
City:
State: Zip Code:
Phone:
Name of Last Supervisor:
Employment Dates:
From: To:
Pay / Salary:
Start: Final:
Your Last Job Title:
Reason for leaving (be specific):








List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.


Name of Employer:
Address:
Address (2):
City:
State: Zip Code:
Phone:
Name of Last Supervisor:
Employment Dates:
From: To:
Pay / Salary:
Start: Final:
Your Last Job Title:
Reason for leaving (be specific):








List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.



May we contact your present employer? NO YES
Did you complete this application yourself? NO YES
If no, who did?

Applicant's Statement

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this 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 applicants 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 further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged 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.

Do you agree to the above statement? NO YES


   

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