Application for Employment

 
PERSONAL INFORMATION Incomplete information could disqualify you from further consideration.
 
First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip:
Email:
Phone:
Cell:
 
Are you eligible to work in the U.S?
 
Are you at least 18 years or older?
 
Do you possess a valid driver’s license?
 
Do you have a valid CDL?
 
If yes, List Class and endorsements:
 
Do you have reliable transportation?
 
Have you received SafeLand Training?
 
Can you work any shift?
 
Can you work overtime, including weekends?
 
Are you willing to travel and stay away from home depending on availability of work?
 
Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
 
Have you ever been convicted of a felony?
 
If yes, provide details:
(A conviction will not necessarily disqualify an applicant for employment.)
 

EMPLOYMENT DESIRED
Position for which you are applying:
 
Date you can start work:
 
Are you currently employed?
 
If so may we inquire of your present employer?
 

REFERRAL SOURCE
How did you hear about us?
 
Referral Name (if applicable)
 
Have you ever worked for this company before?
 
Explain:
 
Do you know anyone who works for our company?
 
If yes, who?
 

EMPLOYMENT HISTORY
Include your last ten (10) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Absolutely no gaps in employment history, MONTH/YEAR REQUIRED. If unemployed or self-employed, please note when applicable.
 
Employer Name:
 
From:
 
To:
 
Street Address:
 
City:
 
State:
 
Phone:
 
Title:
 
Summarize the nature of work performed and job responsibilities:
 
Immediate supervisor and title:
 
Reason for leaving :
 
Hourly Rate/Salary:
 

Employer Name:
 
From:
 
To:
 
Street Address:
 
City:
 
State:
 
Phone:
 
Title:
 
Summarize the nature of work performed and job responsibilities:
 
Immediate supervisor and title:
 
Reason for leaving :
 
Hourly Rate/Salary:
 

Employer Name:
 
From:
 
To:
 
Street Address:
 
City:
 
State:
 
Phone:
 
Title:
 
Summarize the nature of work performed and job responsibilities:
 
Immediate supervisor and title:
 
Reason for leaving :
 
Hourly Rate/Salary:
 

Employer Name:
 
From:
 
To:
 
Street Address:
 
City:
 
State:
 
Phone:
 
Title:
 
Summarize the nature of work performed and job responsibilities:
 
Immediate supervisor and title:
 
Reason for leaving :
 
Hourly Rate/Salary:
 

Employer Name:
 
From:
 
To:
 
Street Address:
 
City:
 
State:
 
Phone:
 
Title:
 
Summarize the nature of work performed and job responsibilities:
 
Immediate supervisor and title:
 
Reason for leaving :
 
Hourly Rate/Salary:
 

Do you have any special skills, experience, certifications, and/or training that would enhance your ability to perform the position applied for?
 
 
If yes, explain:
 

REFERENCES
Give the names of three persons not related to you, whom you have known at least three (3) years.
 
Name:
 
Phone:
 
Email Address:
 
Relationship:

 
Name:
 
Phone:
 
Email Address:
 
Relationship:

 
Name:
 
Phone:
 
Email Address:
 
Relationship:
 

EDUCATION
 
High School:
 
Location (City, State) of School:
 
Did you Graduate?
 
Type of Degree or Certification Received:

 
College:
 
Location (City, State) of School:
 
Did you Graduate?
 
Type of Degree or Certification Received:

 
Vocational, Trade, or Business School:
 
Location (City, State) of School:
 
Did you Graduate?
 
Type of Degree or Certification Received:
 

 
Please read carefully before clicking Submit.

Summit Transport & Environmental, Inc. (ST&E) is an equal opportunity employer. Summit Transport & Environmental, Inc. (ST&E) does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, gender, sexual orientation, marital status, physical or mental disability, or military status.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Summit Transport & Environmental, Inc. (ST&E) to hire me. I understand if offered employment with Summit Transport & Environmental, Inc. (ST&E), the offer will be conditional upon my satisfactory background and drug and alcohol screening results. Due to customer requirements, I understand I may be required to submit a urine, saliva, or hair follicle sample. If I am hired, I understand that my employment is considered “at-will” which means that either Summit Transport & Environmental, Inc. (ST&E) or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Summit Transport & Environmental, Inc. (ST&E) has the authority to make any assurance to the contrary.

By clicking Submit below I have given to Summit Transport & Environmental, Inc. (ST&E) true and complete information on this application. No requested information has been concealed. I authorize Summit Transport & Environmental, Inc. (ST&E) to make such investigations and inquire of my personal, employment, educational, financial or medical history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connections with my application. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.