APPLICATION FOR EMPLOYMENT
Metzler Bros. Tank Truck and Trailer, Inc.
Name: _________________________________________
Phone #: _______________________________________ Alternate Phone #: ___________________________
Social Security No.: ______________________________ DOB: _____________________ Sex: ___________
Present Address: ____________________________________________________________________________
Desired Employment
Position: ___________________ Date Available for Work: ______________ Salary Desired: ____________
Are you employed now? _____________ If so, may we inquire of your present employer? _______________
Ever applied to this company before? __________________ Where? _____________ When? _____________
Ever worked for this company before? _________________ Where? _____________ When? _____________
Reason for leaving? ___________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Name of last supervisor at this company: _________________________________________________________
Education and Training YES NO
Elementary School: _________________________________________Completed: _______________________
Jr. High School: ____________________________________________Completed: _______________________
High School: _______________________________________________Completed: _______________________
College/Major: _____________________________________________Completed: _______________________
Tech School/Major: _________________________________________Completed: _______________________
Other Skills and Training: _____________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Former Employers
List below last three employers, starting with the most recent one first:
1. Name of present employer: _________________________________________________________________
Address: _____________________________________________________________________________
Start Date: _______________ Leave Date: _______________ Job Title: ________________________
Weekly starting salary: ____________ Weekly final salary: _____________ May we contact? ___________
Name of Supervisor: _______________________ Title: _________________ Phone #: ____________________
Description of Work: _________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Reason for leaving? ___________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
2. Name of present employer: _________________________________________________________________
Address: _____________________________________________________________________________
Starting Date: ______________ Leaving Date: ______________ Job Title: ______________________
Weekly starting salary: _____________ Weekly final salary: ____________ May we contact? ___________
Name of supervisor: _______________________ Title: ___________________ Phone #: __________________
Description of work: __________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Reason for leaving? ___________________________________________________________________________
____________________________________________________________________________________________
3. Name of present employer: _________________________________________________________________
Address: _____________________________________________________________________________
Starting Date: ______________ Leaving Date: ______________ Job Title: ______________________
Weekly starting salary: _____________ Weekly final salary: ____________ May we contact? ___________
Name of supervisor: _______________________ Title: ___________________ Phone #: __________________
Description of work: __________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Reason for leaving? ___________________________________________________________________________
____________________________________________________________________________________________
Service Record
Branch of Service: ____________________________________________________________________
Date Entered: _________________________ Date Discharged: ___________________________
Rank: _________________________
Criminal Record
Have you been convicted of a felony within the past five years? ______________________________________
If yes, explain. (This will not necessarily exclude you from consideration) _____________________________
____________________________________________________________________________________________
References
Authorization
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authorization to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is writing and signed by an authorized company representative.
_______________________________________________________________________ _________________________________________
Signature Date