Employment Application

Please Print

First name

Last name

Middle

Cell phone

Home telephone

Mailing Address

City

State

Zip Code

Email address

Employment Desired

Position applying for?

Full or part time

Wage Desired

Are you available for any shift *

YesNo

Are you available for work on weekends *

YesNo

Are you available to work overtime, if necessary *

YesNo

If hired, on what date can you start work?

Personal Information

Have you applied to or worked for Grayson Lumber Company before? *

YesNo

If yes, when?

Do you have friends or relatives working for Grayson Lumber Company? *

YesNo

If yes, state name(s) and relationship

Why are you applying for work at Grayson Lumber Company?

How did you hear about our company?

If hired, do you have a reliable means of transportation to and from work *

YesNo

Are you legally eligible for employment in the U.S.? *

YesNo

Are you at least 18 years of age *

YesNo

Are you currently employed *

YesNo

May we contact your current employer? *

YesNo

Education, Training, and Experience

Highschool

Name

No. of years Completed

Degree or Diploma

Did you graduate

YesNo

Address

College/University

Name

No. of years Completed

Degree or Diploma

Did you graduate

YesNo

Address

College/University

Name

No. of years Completed

Degree or Diploma

Did you graduate

YesNo

Address

Military Service

Branch of Service

From

To

Rank

Duties

Date Discharged

Do you have any other experience, training, qualifications or skills which you feel make you especially suited for work at Grayson Lumber Company? If so, please explain below.

Other experience, training, qualifications or skills

List below three persons not related to you, and who have knowledge of your work performance within the last three years.

Name

Telephone No.

Address

Occupation

No. of year’s acquainted

Name

Telephone No.

Address

Occupation

No. of year’s acquainted

Name

Telephone No.

Address

Occupation

No. of year’s acquainted

Employment History

List below all present and past employment starting with your most recent employer. Account for all periods of unemployment. You must complete this section even if you attach a resume.

Name of Employer

Address

City

State

Zip

Type of business

Telephone No.

Your supervisors name

Your position and duties

Date of employment

Reason for Leaving

Previous Employment

Name of Employer

Address

City

State

Zip

Type of business

Telephone No.

Your supervisors name

Your position and duties

Date of employment

Reason for Leaving

Previous Employment

Name of Employer

Address

City

State

Zip

Type of business

Telephone No.

Your supervisors name

Your position and duties

Date of employment

Reason for Leaving

Certification

My checking of 'Applicants Agreement' certifies that all information in this application is correct and complete to the best of my knowledge and that I understand that providing false, inaccurate, incomplete or misleading information will result in refusal of employment or termination of employment if discovered after date of hire. I acknowledge that the company will verify the accuracy and completeness of the information I have provided and I release each employer, school, or person I have named (or their representatives or agents) to provide information regarding my employment, education, character, and qualifications. I release all entities and individuals who provide information in accordance with this release from all liability for any damages that may result from furnishing information to the company. I understand that if I am employed, I must conform to the company’s rules and regulations and that my employment is “at will” which means that the company or I may terminate my employment at any time for any reason.

Applicants Agreement

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize the company to thoroughly investigate references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships, and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained In any reports furnished to the Company.

I understand that nothing contained in the application or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company’s President.

I understand that Grayson Lumber Company is committed to promoting the safety, health, and productivity of its employees. All applicants who are being considered for employment will be required to submit to a urinalysis examination which will be used to detect the presence of non-perscription drugs and/or alcohol.

Initials