Job Application: General Application

Title: General Application

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

First Name *
Last Name *
Email Address *

Contact Details

Address *
City *
State *
Postal Code *
Primary Telephone *
Secondary Telephone

Expanded Information

Do you have a dependable automobile for deliveries? * Yes
No
Not Applicable
Are you legally able to be employed in the United States of America? * Yes
No
Have you ever been convicted of a felony? * Yes
No
If yes, please explain:

Availability

Date of First Availability
Describe Your Availability and Preferences

Skills

List all skills, talents, and abilities that allow you to perform this job well.

Job History 1

Company Name
Address
Phone Number
Position Title
Supervisor
Starting Date
End Date
Final Pay Rate
Reason for leaving

Job History 2

Company Name
Address
Phone Number
Position Title
Supervisor
Starting Date
End Date
Final Pay Rate
Reason for leaving

Job History 3

Company Name
Address
Phone Number
Position Title
Supervisor
Starting Date
End Date
Final Pay Rate
Reason for Leaving

Reference 1

Name
Relation
Length of Relation
Contact Information

Reference 3

Name
Relation
Length of Relation
Contact Information
Phone Number

Reference 3

Name
Relation
Length of Relation
Contact Information

Education 1

Institution Name
Location (City, State)
Last Level Completed
GPA
Graduated? Yes
No
In Progress
Area of Study/Degree Title

Education 2

Institution Name
Location (City, State)
Last Level Completed
GPA
Graduated? Yes
No
In Progress
Area of Study/Degree Title

Education 3

Institution Name
Location (City, State)
Last Level Completed
GPA
Graduated? Yes
No
In Progress
Area of Studay/Degree Title
 

Additional Documents

Document 1
Document 2

Acknowledgement of Application Policy

I understand and agree that if hired my employment is for no definite period of time, and may regardless of date payment or stated terms of my wages or salary, be terminated at anytime. I understand and agree that my employment relationship with MDC, If hired is an employment-at-will relationship and may be terminated by either myself or the company at any time with or without cause. If I choose to terminate myself, I will give at least a two weeks notice and work the hours appointed at that time. I affirm that the information I have supplied on this application is true and correct, and that I have not knowingly withheld any information. I understand that any misrepresentation of the above information will subject me to dismissal from MDC. I authorize the investigation of all statements contained within this application (and accompaning resume, if supplied). I also authorize the company to contact my present employer (unless otherwise noted on this form), past employers, and references. I authorize any person, school, current employer, past employer, and organi- zations named in this job application (and accompanying resume, if supplied) to provide the company with relevant information and opinions that may be useful to the company in making a hiring decision, and I release such persons and organizations from any legal liability in making such statements. If hired, I consent, upon reasonable circumstance, to searches of any area or property on company premises, including but not limited to lock- ers lunch boxes, coolers, briefcases, purses, and packages. I also consent to random drug test or other test deemed fit at hire and will sign and have notarized a contract stating the conditions of employment if deemed fit. Some information may be used for marketing or promotional purposes at owners discretion. I understand that no person is authorized to change the terms mentioned in the employment application without prior written notice and I understand that this employment application is not intended to be a contract for employment.

Date *
Digital Signature *
 

*