Home
|
Search
|
Online Services
|
Careers
|
About Us
|
Contact Us
|
Employee Login
Online Job Application
Lloyd Companies
APPLICATION FOR EMPLOYMENT
THIS APPLICATION IS GOOD FOR 90 DAYS
FEDERAL LAW OBLIGATES US TO PROVIDE REASONABLE ACCOMMODATION TO THE KNOWN DISABILITIES OF APPLICANTS AND EMPLOYEES, UNLESS TO DO SO WOULD POSE AN UNDUE HARDSHIP. PLEASE FEEL FREE TO LET US KNOW IF YOU NEED AN ACCOMMODATION TO COMPLETE THE APPLICATION PROCESS OR TO PERFORM AN ESSENTIAL ELEMENT OF THE POSITION SOUGHT.
Applicants are considered for all positions, and employees are treated during employment, whithout regard to race, color, religion, sex, national origin, age, disability or any other prohibited basis of discrimination, as provided under applicable state and federal law.
Date of Application:
09/06/2010
Position(s) Applied For:
Refferal Source:
Advertisement:
Friend:
Relative:
Walk-in:
Employment Agency:
Website:
Other:
Last Name:
First Name
:
Middle Name:
Street Address:
City:
State:
ZipCode:
Telephone:
Cell Phone:
Email:
Have you filed an employment application here before?
No:
Yes:
If yes, give date:
Have you ever been employed here before?
No:
Yes:
If yes, give date:
Are you employed now?
No:
Yes:
May we contact your present employer?
No:
Yes:
Are you lawfully becoming employed in this country?
No:
Yes:
If hired, you will be required to submit documents sufficient to establish employment authorization and identity in compliance with the Immigration Reform & Control Act of 1986. While you need not provide this proof of citizenship or immigration status at the time you are interviewed, please be prepared to assure us that you can do so immediately upon being hired.
On what date would you be available to work?
Expected salary:
What Days?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Are you on lay-off subject to recall?
No:
Yes:
Are you available to work:
Full-Time
Part-Time
Temporary
Have you been convicted of a felony within the last 7 years?
(Conviction will not necessarily disqualify applicant from employment. The recency, severity, and pertinence of the conviction will all be considered.)
No:
Yes:
If yes, please explain:
Veteran of the U.S. Military Service?
No:
Yes:
If yes, Branch:
List professional, trade, business , or civic activities and offices held:
(You may exclude those which indicate race, color, disability, religion, sex or national origin)
Give name, address & telephone number of three references who are not related to you and are not previous employees.
School Name
Elementary
High School
College/University
Graduate/Professional
Years Completed
4
5
6
7
8
9
10
11
12
1
2
3
4
1
2
3
4
Diploma/Degree
Describe Studies
Describe Specialized Training, Skills Apprenticeship & Extra-Curricular Activities
Name:
Location:
Length of Course:
Was Course Completed:
No:
Yes:
Subject:
General:
Honors Recieved:
Special Skills/Qualifications, including those acquired from employment or other experience:
Employment Experience:
Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate, for example, race, color, religion, sex, disability or national origin. Failure to complete this section may disqualify you for consideration.
Dates Employed:
Work Performed
Employer:
From:
Address:
To:
Telephone:
Hourly Rate/Salary
Job Title:
Starting:
Supervisor:
Final:
Reason For Leaving:
Dates Employed:
Work Performed
Employer:
From:
Address:
To:
Telephone:
Hourly Rate/Salary
Job Title:
Starting:
Supervisor:
Final:
Reason For Leaving:
Dates Employed:
Work Performed
Employer:
From:
Address:
To:
Telephone:
Hourly Rate/Salary
Job Title:
Starting:
Supervisor:
Final:
Reason For Leaving:
Dates Employed:
Work Performed
Employer:
From:
Address:
To:
Telephone:
Hourly Rate/Salary
Job Title:
Starting:
Supervisor:
Final:
Reason For Leaving:
State any additional information you feel may be helpful to us in considering your application.
APPLICANT´S STATEMENT
These answers are true and complete to the best of my knowledge. The Company may Investigate all statements contained in this application, and I understand that any false or misleading information provided during the application or Interview process will result in my immediate discharge if I am hired, regardless of when discovered. I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. I ALSO UNDERSTAND THAT IF HIRED, REGARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN MYSELF AND THE COMPANY IS TERMINABLE-AT-WILL SO THAT BOTH THE COMPANY AND I REMAIN FREE TO CHOOSE TO END OUR WORK RELATIONSHIP AT ANY TIME FOR ANY OR NO REASON. ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.
I also understand that any offer of employment may be conditioned upon a health evaluation by a doctor selected by the Company, to determine whether I can perform the job duties. In addition, I understand a drug or alcohol test may be required depending upon Company policy. I authorize the Company to make a thorough Investigation of my past employment, education and job-related activities and I release from all liability all persons, companies and corporations supplying such information. I also indemnify this Company against any liability which might result from making such Investigation.
Additionally, I authorize the Company to supply my employment record, in Its sole discretion, In whole or In part, to any prospective employer, government agency, or other party, with an Interest the Company deems appropriate.
Signature of Applicant:
Date:
09/06/2010
Attach your Resume:
