Employment Application

Application for Employment

Date of Application*

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In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

To Be Read by Applicant*

I authorize you to make such investigation and inquiries of my personal, employment, financial or medical history or other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional off of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

Name*

Date*

Driver Applicant Only*

I understand that the information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to: Review information provided by previous employers, have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employers, and have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

Name

Date

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Applicant Information

First Name*

Middle Name

Last Name*

Date of Birth*

Phone*

Social Security No.

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Current Address

Street*

City*

State*

Zip Code*

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*If at the above residence less than three years, list below all residences for the past three years. Attach a separate sheet if necessary.

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Previous Address 1

Street

City

State

Zip Code

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Previous Address 2

Street

City

State

Zip Code

Position Applying For

Time of Work

Rate of Expected Pay?

Who Referred You?

Have you worked for this company before?

Date From

Date To

Position?

Rate of pay?

Reason for Leaving?

Names of any relatives employed by this company?

Are you currently employed?

If not, how long since leaving last employment?

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Education

Highest Grade Completed

College Year Completed

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Last School Attended

School Name

School Address

Have you ever worked for this company under another name?

If so, under what name?

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Employment History

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Employer 1

Employer Name

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Address

Street

City

State

Zip

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Contact Person

Name

Phone

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Date Worked

From

Position Held

Reason for leaving

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Employer 2

Employer Name

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Address

Street

City

State

Zip

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Contact Person

Name

Phone

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Date Worked

From

Position Held

Reason for leaving

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Employer 3

Employer Name

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Address

Street

City

State

Zip

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Contact Person

Name

Phone

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Date Worked

From

Position Held

Reason for leaving

Applicant Must Read and Check

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Driver Requirements & Information

$30.00 per hour-time and a half after eight hours in a shift
Teamsters Local #600
After a 30 day probation period union representation begins.
Initiation Fee - $300.00 (can be deducted from paycheck over time)
Monthly dues - $63.00
Initiation fee and monthly dues are subject to change. To be determined by Union.
8 paid holidays
Health lnsurance-
Central States Health and Welfare Fund
Insured after 90 days with some pre-payment required
$200 deductible
Health, Dental, Vision, Short Term Disability
$20,000 Life Insurance
Company Provided
$10,000 Life Insurance
Short Term Disability
Also Available - AFLAC -cancer insurance, accident insurance, and more.
Vacation
1 year-1 week
2 years- 2 weeks
6 years - 3 weeks
401(k) Retirement Plan
Company matches up to 3% of wages after one year of service if the employee has worked at least 1,000 hours.
Thursday Payday (direct deposit)
Before being put to work
Copy of CDL
Current DOT Physical
Fit for Duty Physical
Negative Drug Test
MVR
Verification of previous employment history
Verification of previous participation in drug & alcohol testing program

*** Please note this is current information that is subject to change based on union contract negotiations.