Batesempap

** Note: All fields are required.**

Contact Information

Full Name:

Email Address:

Date of Application:

Date of Birth:

Phone Number:

Address:

City:

State

Zip Code:

Employment Information

Are you able to work:

Full-Time Seasonal Part-Time

Date that your are available for work:

Have you filled out an application with us before?

Yes No

If “Yes” please give the date:

Are your currently employed?

Yes No

If “Yes” may we contact your present employer?

Yes No

Does any of your friends or relatives (other than spouse_ work here?

Yes No

If “Yes” please state name and relatiionship to person:

Are you legally eligible for employment in this country?

Yes No

Are you currently on “lay-off” status and subject to recall?

Yes No

Can you travel with this job?

Yes No

Have you ever been convicted of a felony within the last 7 years?

Yes No

If "Yes," please explain. (Conviction will not necessarily disqualify applicant from employment.)

Skills & Qualification

Do you have a valid drivers license?

Yes No Radio 3

Do you have a valid CDL?

Yes No

If “Yes”, What Class?

Describe any specialized training, apprenticeship, skills and extracurricular activities or qualifications:

Previous Employment

Most Recent Employer:

Dates Worked:

Address:

Supervisor:

Phone Number

Worked Performed:

Reason For Leaving?:

Employer

Dates Worked:

Address:

Supervisor:

Phone Number:

Worked Performed:

Reason For Leaving?:

Employer

Dates Worked:

Address:

Supervisor:

Phone Number:

Work Performed:

Reason For Leaving?:

Resume (Optional)

Upload Resume Here:

Submit Application:

Applicant’s Statement: I certify that answers given herein are true and complete. I authorize investigation of all statement contained in this application for employment as may be necessary in arriving at an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.