This Application for Employment will remain valid for 30 days from the date received.

It will be reviewed for any open position available during this time frame. After 30 days have passed, a new application must be submitted for consideration for all open positions.

Applicant Information

Today’s Date

Position Applying For

How did you hear about us?

First Name*

Last Name*

County Of Residence*

Telephone*

 

A number of different selection tools and pieces of information are considered as you go through the employee selection, offer and post-offer processes. You may come in contact with some or all of the following:

1. Employment Application
Complete all sections which pertain to you, sign and date. A resume may be required but is not a substitute for completing this Application for Employment. The Application allows the Company to determine your qualifications and experience and contains an Applicant Statement and Agreement. By signing the Application, you authorize the Company to verify the information contained in the Application. Falsification of information on the Application or failure to provide accurate information may result in disqualification from employment or termination of employment if discovered after hire.

2. Employment Interviews
Several personal and/or telephone interviews may be conducted with you in order to obtain more detailed information regarding your background and qualifications. The Company complies with the Americans with Disabilities Act Amendments Act of 2008 (ADAAA). During the interview process you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment, you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, new employees in the same job category will be subject to the same medical questionnaire and/or examination and all information will be kept confidential and in separate files.

3. Employment Eligibility Verification (Form I-9)
This form is required by the U.S. Citizenship and Immigration Services (USCIS). If you are hired, this form will be used to verify your identity and right to work in the United States.

4. Employment Testing
Various tests may be administered to measure your aptitude and abilities in job-related areas. While most tests are short, some exams administered to management level candidates may take several hours.

5. Test for Evidence of Substance Abuse
This may be a urine or saliva test for abusive levels of any chemical substance.

6. Reference Checks
Former employers and educational references are verified prior to an offer of employment.

7. Records Check
There may be verification and information checks with the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus.

8. Physical Examination
Some positions may require the applicant to take a physical examination.

9. Loss Prevention Interview
During this interview, you may be asked questions concerning your Application, any current involvement with illegal drugs, any prior felony or misdemeanor convictions*, any adverse information from prior employers, and other related matters.

*Note: Answering "Yes" to questions regarding prior misdemeanor and felony convictions does not constitute an automatic bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. If may however, limit certain jobs in which you will be considered for within this company.

 

Last Name*

First Name*

M.I.

 

Street Address*

Apt./Unit #

 

City*

State*

Zip Code*

 

Phone*

Email

 

Date Available*

Desired Salary*

 

 

Are you available to work overtime as needed?*

YesNo

Are you able to travel overnight?*

YesNo

Any restrictions on days to work?*

SundayMondayTuesdayWednesdayThursdayFridaySaturday

Employment Status you are applying for*

Full-TimePart-TimeSeasonal

Have you ever worked for TentLogix in the past?

YesNo

If so when?

Have you ever applied for work at TentLogix?

YesNo

If so when?

Do you have any family members working for TentLogix?

YesNo

If so who?

Only US Citizens or aliens who have the legal right to work in the US are eligible for employment. Upon employment, can you submit documentation verifying your legal right to work in the US and proof of your identity?*

YesNo

Note: Answering these questions with an affirmative answer does not necessarily preclude a hiring decision.

Ever been convicted of a misdemeanor?*YesNo
If yes, when / where and nature:

Ever been convicted of a felony?*YesNo
If yes, when / where and nature:

 

EDUCATION

This information may or may not be considered depending on the job in which you are applying for.

High School

Address

From

To

Did you graduate?

YesNo

Degree:

College

Address

From

To

Did you graduate?

YesNo

Degree

Other

Address

From

To

Did you graduate?

YesNo

Degree

 

PROFESSIONAL REFERENCES / NON FAMILY MEMBERS

Please list (2) two PROFESSIONAL references with current NAME, ADRESS and TELEPHONE Number with area code.

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

 

PREVIOUS EMPLOYMENT

Please answer all questions. Resumes are not acceptable in place of this application.

Company

Phone

Address

Supervisor

Starting Salary

Ending Salary

Job Title

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Company

Phone

Address

Supervisor

Starting Salary

Ending Salary

Job Title

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Company

Phone

Address

Supervisor

Starting Salary

Ending Salary

Job Title

Responsibilities:

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Have you ever been terminated or asked to resign from any job*?

YesNo

If yes, please explain:

 

Special Skills and Qualifications

Summarize special job-related skills or qualifications, including licenses and certificates (please give registration number, state and expiration date) acquired from employment or other experience relates to the job which you are applying for.

Skill/Qualification

License/Certificate Number

State

Exp. Date

Skill/Qualification

License/Certificate Number

State

Exp. Date

Skill/Qualification

License/Certificate Number

State:

Exp. Date

 

MILITARY SERVICE

Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable, explain:

 

EQUAL OPPORTUNITY EMPLOYER

TentLogix is an Equal Opportunity employer. The company adheres to a policy of making employment decisions without regard to Race, Color, Age, Sex, Pregnancy. Religion, National Origin, Ancestry, Medical Condition, Marital Status, Citizenship Status, Disability or Uniformed Service Member Status.

2016 / 2017 Application for Employment Applicant Statement and Agreement Disclaimer and Signature

I certify that my answers are true and correct 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.

In connection with my application to the company, I understand that the Fair Credit Reporting Act, Public Law 91-508 & 104-208 requires that I be advised that routine inquiry may be made during the company’s initial or subsequent processing which will provide applicable information concerning character and general reputation. I also understand that investigative background inquiries as required by the Federal Motor Carrier Safety Regulations 391.23 may be made on me including previous employers, along with schools, consumer credit, criminal convictions, motor vehicle records, and other reports.

These reports will include information as to my character, work habits, performance, education, compensation, and experience along with reasons for termination of employment from previous employers. Furthermore, I understand that the company may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil, and other experiences as well as claims involving me in the files of insurance companies. I authorize without reservation, any party or agency contacted to furnish the above mentioned information and release all parties involved from liability and responsibility for doing so. This authorization and consent shall be valid in original, fax, email, other electronic form, or copy form.

I release and agree to hold harmless any individual, company, business institution or government agency from all liability with regard to furnishing information to this company. I agree to release and hold harmless this company from all liability with respect to the receipt of such information.

I certify that this application was only completed by me, and that all entries on it and the information I have furnished on this application form is true and complete. I authorize you to make such investigations and inquiries of my personal, employment, financial, or medical history. (Generally, inquiries regarding medical history will be made only and if a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand false or misleading information given in my application or in interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the Company if a conditional offer of employment is made.

I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49CFR 391.23. I understand that pursuant to 49CFR 391.23 I have a right to: Review information provided by current previous employers; have errors in the information corrected by previous employers and those previous employers to resend the corrected information to the prospective employer; and have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

Drug-Free Workplace Program

I understand that the Company reserves the right to require me to submit to a test for the presence of drugs in my system prior to employment and at any time during my employment, to the extent permitted by law. I hereby consent to a medical examination and the collection of urine, and/or saliva samples (as well as blood or breath samples where applicable and as allowed by law) as requested for the purpose of determining the presence of drugs and/or alcohol, if any. I authorize the release of all medical information obtained during the examination and testing procedure to the Company. I understand that a Drug-Free Workplace program is in effect and that a positive result for the drugs tested may be grounds for termination from employment. I understand that any offer of employment may be contingent upon the passing of a physical examination and satisfactory drug testing. I understand that should I decline to sign this consent or take any of the above tests, my Application may be rejected or my employment may be terminated.

I certify that all information contained in this Application for Employment is true and accurate to the best of my knowledge and belief; and I have read, understand, and agree to be legally bound to all of the terms in the Applicant Statement and Agreement.

Applicant Digital Signature*

Date*

Please leave this field empty.