Application : Precision Husky

NOTICE:THIS INFORMATION WILL NOT BE USED FOR THE PURPOSE OF DISCRIMINATION; EMPLOYMENT AND ADVANCEMENT ARE DETERMINED BY A PERSON’S QUALIFICATIONS AND ABILITIES WITHOUT REGARD TO RACE, CREED, COLOR, AGE, RELIGION, SEX, NATIONAL ORIGIN, DISABILITY OR VETERAN STATUS.

THE QUESTIONS ASKED IN THIS APPLICATION ARE INTENDED TO COMPLY FULLY WITH ALL APPLICABLE LAWS AND REGULATIONS AND YOUR RESPONSE SHOULD BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH SUCH LAWS AND REGULATIONS.

Personal Information

First Name

Last Name

Present Street Address:

City:

State

Zip:

Home Phone:

Cell Phone:

Email:

Permanent Street Address:(if different than present address)

City:

State

Zip:

Please Check "Yes" and fill the content that applies to you correctly, otherwise please select "No".

Are you over 18 yrs. of age?

Yes No

Are you a citizen of the United States?

Yes No

SSN

If not a citizen: (provide the applicable information)

Alien Registration:

Visa Type:

Visa Number:

Have you ever been convicted for violations of any laws other than minor traffic violations? Yes No

(NOTE: Conviction of a crime is not an automatic bar to employment. All circumstances will be considered)')

Schedule

Please provide the work hours you will be available.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Additional Information

Emergency Contact Information

Name and contact information of person, not already listed, who would most likely always know how or where to reach you:

Name

Phone:

Street Address:

City:

State

Educational Background

Highest Grade Level completed:

Other:

Other Schools and Special Training:

Military Service

Dates of Service:

Branch of Service:

Last Rank:

Nature and Duties of any Special Training:

Professional Licenses

There are no professional licenses configured

Name

Street Address:

City:

State

Phone:

Name of Supervisor:

Reason for Leaving:

Dates of Employment (Month, Year):

Starting Pay:

Per:

Salary:
Yes No

Ending Pay:

Per:

Salary:
Yes No

Professional References

Give names and addresses of persons other than relatives who have knowledge of your experience and ability.

Name

Occupation:

Phone:

Street Address:

City:

State

Legal Releases

As part of this selection process: (Select the appropriate answer)

Do you have any objections to our contacting your past employers and academic institutions?

Yes No

Do you have any objections to our contacting your current employer prior to our deciding your suitability?

Yes No

Are you prepared to furnish copies of all certificates, letters of commendation, and evidence of last or current Salary earned?

Yes No

The company is committed to providing a drug-free work place, and successfully completing a drug test is a precondition of employment. Are you prepared to undergo a pre-employment drug screening?

Yes No

In applying for employment with Precision Husky, I certify that:

All information contained in this application is true to the best of my knowledge and belief. Furthermore, I understand that any false statements or representations on my part will result in termination of contract or employment, if contracted or employed; or constitute justifiable reasons for termination of discussion on possible contracts or employment.
I have been advised that a routine investigation in connection with my possible engagement may be conducted. This investigation will check on my character, general reputation, personal characteristics, and mode of living.
I understand that, as a condition of employment with Precision Husky. I will furnish proof of age, and citizenship or legal entry into the United States. I understand that I may be required at the option of Precision Husky, to apply for a US Security Clearance.
I authorize all law enforcement, credit, educational institutions, employers, friends, neighbors, and business acquaintances to furnish the company or a third party a complete history of my record including (but not limited to) my character, habits, abilities, and I release each and the company from any and all liability for damages to me by reason of compliance with your request whether such be due to negligence or errors or any other cause. I further agree that Precision Husky. shall have the right, if and when my contract or engagement is terminated, to furnish others with information regarding my work record.

Application

Personal Information

Schedule

Emergency Contact Information

Educational Background

Military Service

Professional Licenses

Experience Record

Professional References

Legal Releases