Employment :: Feltners Sewer & Drain

- required field.
PERSONAL INFO:
First Name	M.I.
Last Name
	Phone -
Email
Street Address:	Apt. No. or Box
City	State Zip
Are you 18 or older?	Yes No If not, birthdate (xx/xx/xx)

AVAILABILITY:
Total hours available per week
Hours/Days Available
Are you legally able to be employed in the U.S.:	Yes No
How did you hear of job?
How far do you live from Feltners?
Do you have transportation to work?	Yes No

SCHOOL MOST RECENTLY ATTENDED:
School name	School phone
School address
City	State
Teacher or Counselor	Dept.
Last grade completed	Grade point average
Graduated?	Yes No Now enrolled? Yes No
Sports or activities

MOST RECENT JOB:
Company	Phone
Address
City	State
Job	Supervisor
Dates worked from	to (xx/xx/xx) Salary
Reason for leaving

1.) I certify that I have read and fully completed this application and that the information contained on the application is correct to the best of my knowledge and understand that any omission or erroneous information is grounds for dismissal in accordance with company policy. 2.) I authorize references listed on this application to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. 3.) I acknowledge that the company reserves the right to amend or modify the policies in its Handbook and other policies of the company at any time, without prior notice. These policies do not create any promises or contractual obligations between the company and its employees. I acknowledge that my employment is at will. This means I am free to terminate my employment at any time, for any reason, with or without cause, and the company retains the same rights.
The company is an Affirmative action and Equal opportunity Employer. Various Federal, State, and Local laws prohibit discrimination on account of race, color, religion, sex, age, national origin, disability or veterans status. It is the company's policy to comply fully with these laws, as applicable, and information requested on this application will not be used for any purpose prohibited by law.
I understand that as a part of the procedure for my employment application an investigative consumer report may be made concerning my character, general reputation, personal characteristics and mode of living. Upon written request, additional disclosure concerning the complete nature and scope of the investigation will be provided. If I am denied a job based either wholly or in part because of information contained in an investigative consumer report, I will be provided the name and addresses of the reporting agency that supplies the information.
	By checking this box I agree that all of the above information is accurate.
	Date (xx/xx/xx)