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This application form is intended for use in evaluting your qualification for employment. This is not an employment contract. Please answer all appropriate questions completley and accuratley. False or misleading statements during the interview and on this form are grounds for terminating the application process or if discovered after employment, terminating employment. All qualified applications will recieve consideration with discrimination because of sex, marital status, race, color, age, creed, national origin, or presence of disabliities. A felony conviction will not necessarily bar an applicant from employment. Additional testing of job-related skills and for the presence of drugs in your system may be required prior to employment. You will be required to complete a medical history form.

Are you of 18 years or older?

Current Address

Previous Address

Availability

What category would you prefer?

Which schedule are you available?

Available for out-of-town work?

Job-Related Skills

NOTE: Do not fill out any part of this section you believe to be non-job related

If the job requires, do you have the appropriate valid driver's license?

If you have a CDL, have you tested positive for a drug test in the last three years?

Have you had any moving violations?

Have you been convicted of, or served time for a felony?

If so, please describe in the boxes below. (In accordance with company policy, this information will be reviewed for job relatedness and time since last convictions)

Most Recent Employer

Are you currently working for this employer?

If yes, may we contact?

Dates Employed

Education

High School

College

Other