Equipment Plus Foodservice Inc. Employment Application

Applicant Information
Full Name: Date:
Address:  City:  
State:     Zip: Phone:
Email Address: Date Available:
SS Number:  Desired Salary:  $
Position Applied For:  
Are you a citizen of the United States?      Yes  No If no are you authorized to work in the U. S.?  Yes  No
Have you ever worked for this company?    Yes  No If yes, when?
Have you ever been convicted of a felony?  Yes  No  
If yes, please explain:
   

Education
High School: Address:
From:    To: Did you Graduate? Yes  No  Degree:
College: Address:
From:    To: Did you Graduate? Yes  No  Degree:
Other: Address:
From:    To: Did you Graduate? Yes  No  Degree:
   

Skills/Certifications/Licenses
Please list and any skills certifications and or licenses you may have:
   

References

Please list 3 professional references.  
Full Name: Relationship:
Company: Phone:
Address:  
   
Full Name: Relationship:
Company: Phone:
Address:  
   
Full Name: Relationship:
Company: Phone:
Address:  
   

Previous Employment
Company: Phone:
Address: Supervisor:
Job Title: Starting Salary: $  Ending Salary: $
Responsibilities:
From:   To: Reason for leaving:
May we contact your previous supervisor for a reference? Yes  No
   
Company: Phone:
Address: Supervisor:
Job Title: Starting Salary: $  Ending Salary: $
Responsibilities:
From:   To: Reason for leaving:
May we contact your previous supervisor for a reference? Yes  No
   
Company: Phone:
Address: Supervisor:
Job Title: Starting Salary: $  Ending Salary: $
Responsibilities:
From:   To: Reason for leaving:
May we contact your previous supervisor for a reference? Yes  No
   

Driving Record / Background Check Information
DL #: State:
SS #:  
   

Disclaimer And Signature
I certify that my answers are true and complete to the best of my knowledge.  By clicking the electronic signature below, I authorize Equipment Plus, or any company working on behalf of Equipment Plus, to perform a credit check, criminal background check and driving record check.  I also authorize Equipment Plus to contact any employers or references listed for references purposes, unless otherwise noted.

I understand that completion of the application in no way guarantees an interview or offer of employment.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Electronic signature.  By checking this box you are signing your signature  Date: