Discount Steel
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Employment Application

 (Please be advised that incomplete applications will not be considered.)

Our Company fully subscribes to the principles of Equal Employment Opportunity. It is our policy to provide employment, compensation, and other benefits related to employment based on qualifications, without regard to race, color, religion, national origin, age, sex, veteran status, genetic information, disability, or any other basis prohibited by federal, state or local law. In accordance with requirements of the Americans With Disabilities Act and applicable state laws, it is our policy to provide reasonable accommodation upon request during the application process to eligible applicants in order that they may be given a full and fair opportunity to be considered for employment. As an Equal Opportunity Employer, we intend to comply fully with applicable federal and State employment laws and the information requested on this application will only be used for purposes consistent with those laws.

 

This application must be filled out in its entirety. For items that do not apply to you, respond with N/A.


Company Name: 
Position Applied For: 
Application Date:  12/04/2016

Personal Data
Salary Expectations: 
First Name:  Middle Name:  Last Name: 
Address: 
City:  State:  Zip: 
Telephone:  - -
Email: 
If you are under 18 years of age, please specify your age:
   (This information will be used only for child labor law purposes).
Are there any days, shifts or hours you will not work? 
Are you available for out of town work? 
Will you work overtime, if required? 
When will you be able to start work?
How did you learn of our Company?
If referral, who were you referred by?
Have you ever applied or worked at our Company before? 
Are you legally authorized to work in the United States? 
Will you now or in the future require sponsorship for employment visa status (e.g.,H-1B visa status)? 
Note: The Federal Immigration and Reform and Control Act of 1986 requires that a DHS Employment Eligibility Verification “Form I-9” be completed for every new hire and that within 3 business days of beginning work every new hire must present to the employer documentation establishing his/her identity and authorization to work. This federal requirement must be satisfied as a condition of employment.

Driving Record
Do you have a valid driver’s license? 
Have you had any tickets? 

Education
Describe any educational degrees, skills, training or experience you believe are relevant to the job applied for:

Name, City and
State of
Educational
Institution
Graduated? If no, Degree
Credits Earned
Type of Degree
Received or
Expected
Major Minor Grade Point/
Overall GPA
High School
Name:

College or
University
Name:

                   
Licenses /
Certification / Other
Name:

                   
Employment History:
Please complete for all full-time or part-time employment beginning with most recent employer. You may include as part
of your employment history any verified work performed on a volunteer basis. All applicants should start with their
most recent job, include active military assignments and voluntary employment and provide fifteen (15) years of history.
(A separate sheet may be attached.) Explain any gaps in your employment history.



1)
Company Name:  Telephone: 
Address: 
Name of Supervisor: 
Dates Employed:  From:  To: 
Rate of Pay:  Start:  End: 
Job Titles and Duties: 
Reason For Leaving: 

2)
Company Name:  Telephone: 
Address: 
Name of Supervisor: 
Dates Employed:  From:  To: 
Rate of Pay:  Start:  End: 
Job Titles and Duties: 
Reason For Leaving: 

3)
Company Name:  Telephone: 
Address: 
Name of Supervisor: 
Dates Employed:  From:  To: 
Rate of Pay:  Start:  End: 
Job Titles and Duties: 
Reason For Leaving: 

4)
Company Name:  Telephone: 
Address: 
Name of Supervisor: 
Dates Employed:  From:  To: 
Rate of Pay:  Start:  End: 
Job Titles and Duties: 
Reason For Leaving: 

5)
Company Name:  Telephone: 
Address: 
Name of Supervisor: 
Dates Employed:  From:  To: 
Rate of Pay:  Start:  End: 
Job Titles and Duties: 
Reason For Leaving: 

Please explain any gaps in your employment history:
Have you ever been discharged or forced to resign? 
Did you receive any discipline in your last 12 months of active employment with your previous employer? 
Were you given a performance evaluation within the last 12 months of active employment? 
Have you signed any non-competition or non-solicitation agreement with any other employer that might restrict you from
working for this company (you may be required to furnish a copy of the agreement)? 

References
Please list three persons not related to you who know your qualifications.

Name Address Phone Relationship
               
               
               

Military
(Complete only if you served in the military.)

Branch of Service:  Number of Years /Months of Service: 
Rank at Discharge:  Date of Discharge: 

Reason for Leaving:

Describe any military skills, training or experience you believe are relevant to the job you applied for:
Describe any education, work experience, volunteer or community service, skills, or specialized knowledge
that would make you a good candidate for this position.

APPLICANT’S ACKNOWLEDGMENT

I certify that the answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts or incomplete answers in any application document may disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts in any application document may be cause for my dismissal at any time without prior notice. I consent to and authorize this Company to contact my former employers, references, and any and all other persons and organizations for information bearing upon my qualifications for employment. I further authorize the listed employers, schools and personal references to give the Company (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have and hereby waive any actions which I may have against either party(ies) for providing a good faith reference.

I EXPRESSLY AGREE AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT IS NOT FOR A SPECIFIC TERM, IS BASED ON MUTUAL CONSENT AND MAY BE TERMINATED BY ME OR MY EMPLOYER WITH OR WITHOUT NOTICE OR CAUSE AT ANY TIME. I FURTHER UNDERSTAND THAT NO ORAL PROMISE, EMPLOYER POLICY, CUSTOM, BUSINESS PRACTICE, NON-COMPETE AGREEMENT, CONFIDENTIALITY AGREEMENT, OR OTHER PROCEDURE (INCLUDING THE BASIC EMPLOYMENT POLICIES, PERSONNEL HANDBOOK OR ANY PERSONNEL MANUALS) CONSTITUTES AN EMPLOYMENT CONTRACT OR MODIFICATION OF THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ME AND THE EMPLOYER. I ALSO UNDERSTAND THAT THIS ASPECT OF MY EMPLOYMENT MAY NOT CHANGE ABSENT AN INDIVIDUAL WRITTEN AGREEMENT SIGNED BY BOTH ME AND THE PRESIDENT OF THE COMPANY.

I UNDERSTAND THAT APPLICANTS FOR CERTAIN POSITIONS MAY BE REQUIRED TO QUALIFY FOR EMPLOYMENT BASED ON ADDITIONAL EMPLOYMENT CRITERIA. FOR EXAMPLE, I MAY BE REQUIRED TO TAKE JOB-RELATED TESTS, SUBMIT TO CERTAIN BACKGROUND SCREENINGS, AND TAKE A DRIVER'S EXAMINATION. ALL JOB OFFERS ARE CONTINGENT UPON SUCCESSFUL COMPLETION OF A DRUG TEST, CRIMINAL BACKGROUND SCREENING, EMPLOYMENT VERIFICATION AND EDUCATIONAL DEGREE VERIFICATION. I AUTHORIZE THE RELEASE OF ANY BACKGROUND CHECK RESULTS OF ANY DRUG/ALCOHOL TEST TO ANY STATE OR FEDERAL AUTHORITY REQUESTING SUCH INFORMATION AND IN RESPONSE TO A VALID SUBPOENA OR OTHER LEGAL DOCUMENT.

Electronic submission of this application and conformed signature thereon shall be deemed an original signature and enforceable thereby as if signed in person.

I certify that I have read and agree to the above disclaimer
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