EMPLOYEE APPLICATION

Full Name:
Your Email Address:
Confirm Email Address:
Current Address:
City, State & Zip:
Phone Number:
Employment Desired
Position Desired:
Salary Desired:
Desired Start Date?
Do you possess a valid driver's license?

Yes                    No

Are you legally authorized to be employed in the USA?

Yes                    No

Have you ever been convicted of a criminal offense? Yes                    No

Have you ever been convicted of a criminal offense? If so, explain below:

 

Employment History
List all work experience beginning with your current or most recent position.
Most Recent Position
Company Name:
Employment Start and Finish Dates:
Position:
Salary:
Reason for Leaving:
Description of Responsibilities:
   
Second Most Recent Position
Company Name:
Employment Start and Finish Dates:
Position:
Salary:
Reason for Leaving:
Description of Responsibilities:
   
Third Recent Position
Company Name:
Employment Start and Finish Dates:
Position:
Salary:
Reason for Leaving:
Description of Responsibilities:
 


Statement of Purpose:
The information that you provide on this application is subject to verification. Falsifications or misrepresentations may disqualify you from consideration for employment, if hired, may be grounds for termination at a later date. With my signature below, I certify that all information on this application is true, correct and complete to the best of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to releaase job related information they may have about me and I release all persons or companies from any liability for providing such information.

 

Type Full Name:
Type Initials:
Please print this page for your own records before submitting to Butler Auto Recycling, Inc.
Date: