Online Employment Application Form

The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, sex, religion, or national origin. Public Law 90-202 prohibits discrimination because of age. The laws of some states prohibit some or all of the above mentioned types of discriminations.

Last Name

First Name

Middle

Address

City

State

Home Phone

Cell Phone

Email Address

Birth Date

Gender

Marital Status

Job Applying for #1

Job Applying for #2

How did you hear about opening?

Social Security Number (optional)

Driver's License Number

Are you a U.S. Citizen?
YESNO

Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
YESNO

If yes, please describe in detail

Have you ever been convicted of a felony?
YESNO

If yes, please describe in detail

Do you have a reliable means of transportation to get to work?
YESNO

Education

Please List all Past Education

Other Training or Certificates

Employment History

Employer (#1)

Dates Employed

Work Phone

Address

City

State

Position

Pay Rate

Duties

Supervisor's Name

Reason for Leaving

May We Contact Them?
YESNO

 

Employer (#2)

Dates Employed

Work Phone

Address

City

State

Position

Pay Rate

Duties

Supervisor's Name

Reason for Leaving

May We Contact Them?
YESNO

 

Employer (#3)

Dates Employed

Work Phone

Address

City

State

Position

Pay Rate

Duties

Supervisor's Name

Reason for Leaving

May We Contact Them?
YESNO

 

References

Name

Title

Phone


Name

Title

Phone


Name

Title

Phone

 

To assist us in finding the proper position for you in our organization, please use the space below to summarize additional information necessary to describe your full qualifications.

What interests you most in working for Williams and Hall?

I certify that all answers given are true and complete to the best of my knowledge.
YES

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
YES

In the event of employment, I understand that false of misleading information given in my application or interview(s) may result in discharge.
YES

PHOTOGRAPH

RECOGNIZED HAZARDS

Williams and Hall endorses and supports the right of all employees to work in an environment free of recognized hazards. Therefore, the use of nonprescribed drugs, tobacco, or alcohol products is not acceptable within company facilities or on company property or in company vehicles. I acknowledge and will abide by the above statements (required). YES

PLEASE READ CAREFULLY. APPLICANT’S CERTIFICATION AND AGREEMENT

US law requires that, if hired, you must furnish appropriate documentation establishing identity and employment eligibility, generally within 72 hrs of starting work. For example, acceptable documents include: a US Passport, or INS Forms 688 or 688A, a Social Security Card or birth certificate by government authority and a drivers license, school ID with photo or other government issued documentation establishing identity.

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice.

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.

Electronic Signature

Date