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Wilmington, NC
, Cape Fear Pick N Pull
Conway, SC
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Employment Application
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*
" indicates required fields
Have you been previously employed by Carolina Pick N Pull or any of its affiliates
Yes
No
Dates of Employment (From)
MM slash DD slash YYYY
Dates of Employment (To)
MM slash DD slash YYYY
Position Applied For
*
Location
*
Wilmington, NC
Fayetteville, NC
Conway, SC
Type of employment desired:
Full-time
Part-time
Personal Information
Name
*
Address
*
Street Address, City, State, & Zip
Phone
*
Date Available
MM slash DD slash YYYY
Employment History
List most recent employers/positions first
Employer
Employer Address
Street Address, City, State, & Zip
Employer Phone
Position Title
Employed From (mo/yr)
Employed to (mo/yr)
Duties
Supervisor
Last wage/salary
Wage
per
time-frame
Reason for leaving
Employer #2
Employer
Employer Address
Street Address, City, State, & Zip
Employer Phone
Position Title
Employed From (mo/yr)
Employed To (mo/yr)
Duties
Supervisor
Last wage/salary
Wage
per
time-frame
Reason for leaving
Employer #3
Employer
Employer Address
Street Address, City, State, & Zip
Employer Phone
Position Title
Employed From (mo/yr)
Employed To (mo/yr)
Duties
Supervisor
Last wage/salary
Wage
per
time-frame
Reason for leaving
Skills
List any special skills you have. In addition, list special equipment you can operate:
Education/Training Background
High School Graduate
Yes
No
GED
School
Date Graduated
Trade school or certification
Yes
No
School
Trade studied/Certification
College or university
Yes
No
Degree
School
Dates Attended
Qualifications
Are you legally eligible for employment in the United States?
*
Yes
No
Are you able to perform the essential functions of the position applied for with or without reasonable accommodations?
Yes
No
If hired, can you furnish proof that you are 18 years of age or older, or if under 18, do you have a permit to work?
*
Yes
No
If No, explain:
Have you been convicted of a felony or released from prison in the past five years?
*
Yes
No
Note:
A “Yes” answer does not automatically disqualify you from employment since the nature of the offense, date, and type of job for which you are applying will be considered. You may omit information regarding convictions that have been expunged.
Consent
*
AUTHORIZATION AND ACKNOWLEDGEMENTS
I affirm that the information I have provided in this application is true to the best of my knowledge, information and belief, and I have not knowingly withheld any information requested. I understand that withholding or misstating any information requested in this application is grounds for rejection of my application, and that providing false or misleading information in this application is grounds for discharge.
I authorize the company to verify my references, record of employment, education record, and any other information I have provided. Unless otherwise noted, I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to such inquiry or disclosure.
I also understand that as a prerequisite to being employed by Carolina Pick-N-Pull I will be required to take a drug screening test by way of urinalysis or blood analysis performed by a physician designated by Carolina Pick-N-Pull. Employment is contingent upon the drug screening analysis revealing that I am drug free.
ACKNOWLEDGEMENT OF PROBATIONARY PERIOD
This is to certify that I am aware that if I am made an offer of employment and accept, for the first sixty (60) working days of my employment, I will be working for Carolina Pick-N-Pull in a probationary capacity. During this sixty (60) day probationary period, all facets of my work will be under evaluation including attendance, conduct and competence. The areas of competence that I will be rated on include judgment, organization and planning, initiative, flexibility, work standard, cooperation, and technical knowledge. I am aware that I will be eligible to receive Worker’s Compensation Insurance and that there are waiting periods for certain other benefits such as group insurance. I also understand that in the event of a Worker’s Compensation claim involving lost time, I may be required to perform another job within the work restrictions outlined by Carolina Pick-N-Pull’s doctor.
I also agree that Carolina Pick-N-Pull will not be held for any expenses incurred by me which are related to my employment with Carolina Pick-N-Pull should I be terminated for unsatisfactory performance during the probationary period.
I agree
*
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