4K Equipment Application
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Today's Date
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Date available for employment
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Name
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Email address
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Date of birth
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Physical Address
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Mailing address (if different)
Cell phone
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Position applying for
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Wage desired
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Availability
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Full-time
Part-time
If part time, detail available times
Are You Currently employed?
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yes
no
Have you ever been asked to resign from a job?
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Can you provide proof that you can work in the US?
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Have you ever been convicted of a felony?
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Employment History
1. Company name
Company address
Phone number
Dates employed
Job duties
Reason for leaving
May we contact this employer?
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Name and phone number of employer
2. Company name
Company address
Phone number
Dates employed
Job duties
Reason for leaving
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Name and phone number of employer
3. Company name
Company address
Phone number
Dates employed
Job duties
Reason for leaving
May we contact this employer?
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Name and phone number of employer
4. Company name
Company address
Phone number
Dates employed
Job duties
Reason for leaving
May we contact this employer?
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Name and phone number of employer
Please explain any gaps in your employment history
Please list a minimum of three people, who are not related to you, that are familiar with your abilities and work history. Please Include their name, their relationship to you, and their phone number or email.
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Education
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Do you have a high school diploma?
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Please list any other experience or qualifications
Application Statement and Agreement
I certify that all answers and statements I have made on this application (and resume or other supplementary materials) are true and complete without omissions. I understand that any false information will be grounds for refusal to hire or for immediate discharge if I am employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, and qualifications.
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I will be responsible for familiarizing myself with all rules and regulations of 4K Equipment as they presently exist or are later modified. I recognize that my employment can be terminated, at the discretion of 4K Equipment, or at my option, without notice, at any time. With the exception as specifically set forth in writing in a current individual employment agreement.
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I understand that no representative of 4K Equipment has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms, and conditions of employment, except as specifically stated in a current written agreement signed by the President.
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I understand that the information that has been provided may be used, and prior employers may be contacted for the purpose of investigating the background as required by §391.23.
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This certifies that this application was completed by me, and that all the entries on it and information in it are true and complete to the best of my knowledge.
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Date
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Please type your name to sign
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