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| Employment Desired |
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Can you work any shift?
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If hired, would you be able to work overtime as needed, including weekends?
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| List any seminars, classes or other education not listed above which may help qualify you for this position. |
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| Employment History |
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List below last four employers, starting with your most recent employer. Account for all periods of unemployment. |
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Current employer?
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| What value did you add to this company or its customers? |
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| What value did you add to this company or its customers? |
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| What value did you add to this company or its customers? |
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| What value did you add to this company or its customers? |
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| Have you ever applied for employment with this company before? |
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| If Yes, when? |
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| Do you have any friends or relatives employed by this company? |
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| If Yes, please provide their names and relationship to you: |
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Are you currently employed?
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May we contact your employer?
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Are you currently on "lay off" status and subject ot recall?
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If you are under 18 years of age, can you provide proof of your eligibility to work?
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| If hired, can you provide proof of U.S. citizenship or proof of your legal right to work in the U.S.? |
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| Have you ever been terminated from employment or asked to resign by an employer? |
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| If yes, please provide company names and details. |
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| If hired, do you have a reliable means of transportation to and from work? |
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| Do you have any special skills, experience and/or training. That would enhance your ability to perform the position applied for? |
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| If yes, explain: |
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| Have you ever been convicted of a felony or misdemeanor? |
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| If Yes, please explain: |
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A criminal record does not constitute an automatic bar to employment and will be considered only as it substantially relates to the job in question. |
| References |
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List below three persons not related to you who have knowledge of your work performance within the last 5 years. |
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| Additional Space |
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Additional space provided to expand on any points or questions asked previously in this application: |
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Please read each statement closely and initial each acknowledging your understanding. |
Equal Employment Opportunity Statement |
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This company is committed to the principles of equal employment opportunity and is committed to make employment decisions based on merit. We are committed to complying with all Federal, State and local laws providing for equal opportunities, as well as all laws related to terms and conditions of employment. The Company desires to maintain a work environment free of harassment and discrimination due to sex, race, religion, color, national origin, physical or mental disability, age, sexual orientation, genetic information, military status or any other status protected by Federal, State and local laws. The Company will make reasonable efforts to accommodate those physical or mental limitations of an otherwise qualified employee unless undue hardship would result for the company. |
Disclosure to Applicants Concerning Drug/Alcohol Testing |
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If you are offered a position with the Company, you may be given a drug/alcohol test as a condition of employment. Your refusal to timely submit to a drug/alcohol test or your failure to pass such a test means you will not be employed by this company. Negative test results are required as a condition of employment. |
Complete and Accurate Information |
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I hereby certify that I have not withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission or misstatement of fact on this application, or any other document used to secure employment, shall be grounds for rejection of this application or for the immediate discharge if I am employed, regardless of the time elapsed before discovery. |
At-Will Employment |
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I understand and agree that if I am employed, my employment will be "at-will", which means that the Company may terminate the employment relationship at any time, with or without cause and with or without notice. Likewise, the Company will respect my right to terminate my employment at anytime, with or without cause and with or without notice. I further understand that any prior representation, whether expressed or implied to the contrary is hereby superceded and that no promise or representation contrary to the foregoing is binding on the Company unless made in writing and signed by the Company’s president. |
Testing Authorization |
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If offered a position with the Company, I hereby agree to any legally permitted physical, psychological, skill, drug or medical test required by the Company as a condition of employment. |
Investigation Authorization |
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I authorize investigation into all statements and references contained in this application. Said investigation may include credit, driving, criminal background, references and other background checks. All investigations utilizing an outside credit reporting agency shall be conducted pursuant to the Fair Credit Reporting Act. |
Employment Agreement |
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I understand that as a condition of employment, GeoCorp requires all employees to execute an Employment Agreement that includes a Non-Competition Covenant and a Confidentiality Agreement. By applying for this job, I also represent that I have no contract or agreement with a prior employer that would preclude or impair my employment with GeoCorp. |
Company Obligation |
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I understand and agree that the Company’s acceptance of this job application does not mean that a position for which I am qualified for is open, or that the company has agreed to hire me. I understand that the Company is under no obligation to hire me as a result of accepting this completed application. |
| I HAVE READ AND UNDERSTAND THE ABOVE POLICY STATEMENTS AND AGREE TO BE BOUND BY THEM IF EMPLOYED BY THE COMPANY. |
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Date: |
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