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Captures employment desired data such as position, earliest start date, desired salary, current employment status, prior applications, and referral information. 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Yes  No   \nAre you prevented from lawfully becoming employed in this country because of Visa or immigration status? Yes   No   \nEMPLOYMENT DESIRED  \nPosition:   \nDate You Can Start: / /   \nSalary Desired: $ /HOUR or $ /YEAR  \nAre you employed now? Yes   No   If yes, may we inquire of your present employer? Yes   No   Ever Applied To This Company Before? Yes  No  Where? When? / /  Referred By:   \nFORMER EMPLOYERS (LIST BELOW LAST TWO EMPLOYERS, STARTING WITH LAST ONE FIRST)  \n\n| Date (mo. & year) | Name/Address Of Employer | Salary | Position | Reason For Leaving |\n| --- | --- | --- | --- | --- |\n| From |  |  |  |  |\n| To |  |  |  |  |\n| From |  |  |  |  |\n| To |  |  |  |  |\n\nI hereby affirm: The information in this application is true and accurate. If any of the information turns out to be false or misleading,   (Hereby referred to as “COMPANY”may dismiss me immediately in its sole discretion. If hired, I agree to provide documentation authorizing me to work in the United States. I authorize COMPANY to contact my former employers for relevant information about me; and I authorize COMPANY to release the information herein, as reasonably required, to any employee of COMPANY , or insurance company; and I authorize COMPANY to give future prospective employers relevant information about my employment, if so requested. I understand my employment may be conditioned upon my passing a physical examination, and/or a drug and alcohol test, and if hired, I agree to be subject to alcohol and drug testing for my safety and the safety of others; and in connection with any job-related injuries, as COMPANY deems necessary. I understand and agree that the terms and conditions set forth in the COMPANY policy manual(s), including those entitled “Substance Abuse Policy”; “Occupational Injury Indemnity and Medical Benefits” and others are incorporated herein and are a part of my employment, and that I have had the opportunity to review the Policies, and fully understand and agree to them.  \nPrint Name:    \nSignature:  Date: / /","cbCaiqhZWfOTjsrg","https://ap.wps.com/l/cbCaiqhZWfOTjsrg","pdf",66500,"English","# Applicant Information\n# Employment Desired\n# Former Employers\n# Certification and Signature","[{\"question\":\"What applicant information does the form request?\",\"answer\":\"It requests the applicant’s last SS#, name fields, present and permanent address details, and phone number, along with eligibility questions about age and lawful employment status.\"},{\"question\":\"What employment details are included under Employment Desired?\",\"answer\":\"The form captures the desired position, the date the applicant can start, salary expectations (hourly or yearly), whether the applicant is currently employed, and whether permission is granted to contact the current employer and prior application history.\"},{\"question\":\"How does the form handle former employers and applicant authorization?\",\"answer\":\"It includes space for the last two employers with dates, salary, position, and reasons for leaving, and the applicant must affirm the information’s truth, authorize the company to contact former employers and release relevant employment information, and agree to testing and policy terms if hired.\"}]","Employment Application - New Hire Form | PDF",1789838189]