*Last Name:
*First Name
*Driver's License State:
*Driver's License Number:
*Driver's License Expiration Date:
*Has your license ever been suspended? If yes, explain where and why:
*List driving violations from the past 5 years. If none, answer zero.
*Date of Birth:
*Home Phone Number with Area Code: If none, answer none.
*Cell Phone Number with Area Code:
*Street Address:
*City & State:
*Zip code:
Do you have a Career Readiness Certificate?
What was your Career Readiness Certificate letter grade?
*If hired can you provide proof that you will qualify as a driver?
*Are you a citizen of the United States?
If not a citizen, are you prevented from becoming legally employed because of visa or immigration status? (Answer Yes or No. If No, please explain):
*Wage desired:
How did you find out about this position?
*When are you available to start work?
*Are you looking for Permanent or Seasonal employment?
*What is your availability?
*Maximum weight you are capable of lifting on a regular basis:
*Are you currently employed?
EDUCATIONAL BACKGROUND
*Are you currently in school?
*Highest grade of High School completed:
High School Name:
High School Address:
Name of College Trade or Business School attended:
College, Trade or Business School address:
Number of College, Trade or Business School years completed:
College, Trade or Business School area of studies:
College, Trade or Business School degree or certification:
List any other skills, special knowledge, qualifications or certifications:
Upload Current Resume (If submitting resume, skip the Employment History portion of this form.)
EMPLOYMENT HISTORY We will ask about your past three jobs. About your most recent job:
[1] Employer Name:
[1] Dates of Employment (month/year - month/year):
[1] Supervisor Name:
[1] Supervisor Phone Number:
[1] May we contact your supervisor?
[1] Your Job Title:
[1] Duties & Responsibilities:
[1] Wages:
[1] Reason for leaving:
About the job before your most recent job:
[2] Employer Name:
[2] Dates of Employment (month/year - month/year):
[2] Supervisor Name:
[2] Supervisor Phone Number:
[2] May we contact your supervisor?
[2] Your Job Title:
[2] Duties & Responsibilities:
[2] Wages:
[2] Reason for leaving:
About the job before job [2]:
[3] Employer Name:
[3] Dates of Employment (month/year - month/year):
[3] Supervisor Name:
[3] Supervisor Phone Number:
[3] May we contact your supervisor?
[3] Your Job Title:
[3] Duties & Responsibilities:
[3] Wages:
[3] Reason for leaving:
*Professional Reference Name:
*Professional Reference, Work Relationship:
*Professional Reference, Number of years they have known you:
*Professional Reference Phone Number:
Anything else you want to tell us?
Email Address:
*I hearby agree to submit to any drug test required, whether prior to my employment or if employed by this company at any time thereafter. Enter your initials to answer "YES".
FINAL STEP
I certify that the information in the application is correct to the best of my knowledge.
I understand that in order to be considered for employment, I will need to provide Big Ten Rentals with my social security number.
By submitting this application, I hereby authorize all corporations, companies, credit agencies, schools, government agencies, persons, military service, and former employers to release information they may have about me to, Big Ten Rentals, Inc. or its agents and employees, and release all persons or companies from liability or responsibility from doing so. Further, I authorize the procurement of a consumer report, credit check and department of motor vehicle records. I understand that such a report may contain information about my background, character, and personal reputation. I understand that this notice will also apply to any future update reports.
I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge. Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer. If requested, I will take a post job-offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician. I further understand this is an application for employment and no employment contract is being offered. I understand that if I am employed, such employment is for an indefinite period of time and the company may change wages, benefits, and conditions at any time. My employement is at will. No individual with the company is authorized to change the employment-at-will status except an officer of the company, who may do so only in writing. I have read and agree to the above.
Note: After the Submit Application button is pressed,
the "back to form" button must be used to return to the form.Pressing your browser's "back" button will erase your application data.
