Application

Your name Address City State Zip Phone Number Your email Work Availability WeekdaysWeekendsBoth Select Days you are unavailable to work MTWThFSSn Have you been you ever been convicted of a crime, excluding misdemeanors and summary offense, which has not been annulled, expunged, or sealed by court? YesNo If yes, explain: EDUCATION High School From To Did you Graduate? YesNo College From To Did you Graduate? YesNo PREVIOUS EMPLOYMENT Company Name Address Phone Job Title Responsibilities From To Reason for Leaving Company Name Address Phone Job Title Responsibilities From To Reason for Leaving DRIVING HISTORY Do you have valid Driver's License or Photo Id? YesNo DL/ID # State Exp. Date Are you able to Drive Box Trucks? YesNo If yes, how many years experience? Have you ever been in any accidents while driving a motor vehicle? YesNo If yes, briefly explain? MEDICAL HISTORY Are you able to work outdoors/stand for an extended period of time? YesNo Have you had COVID-19? YesNo If yes, provide date: Have you been vaccinated? YesNo If yes, provide date of final shot? if you have you not been vaccinated, do you plan on being vaccinated? YesNo If No, briefly explain why? Do you have any medical conditions that may affect your ability to work? yesno If yes, briefly explain? This job requires heavy lifting, a minimum of 50lbs Are you physically capable of working for this company with no complications? YesNo If no, briefly explain? If selected for employment, are you will to submit a pre-employment drug screening test? YesNo DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge If this application leads to employment. I understand that false or misleading information in my application or interview may result in my release. Signature Date Upload your Resume (optional) ] Your message (optional)