- Grammar School
- High School
- Trade, Business or Correspondence School
- EXCLUDE ORGANIZATIONS, THE NAME OF WHICH INDICATES THE RACE. CREED. SEX. AGE. MARITAL STATUS, COLOR OR NATION OF ORIGIN OF ITS MEMBERS.
(List Below Last Three Employers Starting With Last One First).
- Date Month & Year(From & To)
- Name and Adress of Employer
- Reason For Leaving
Give the names of three persons not related to you, whom you have known at least one year.
- The Following Statement Applies in: MARYLAND & MASSACHUSETTS. [Fill in name of state.;
- TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST
AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND CIVIL LIABILITY.
- IN CASE OF EMERGENCY NOTIFY
*I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.
IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANY'S RULES AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE. AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT EITHER MY OR THE COMPANYS OPTION. I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAY BE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME BY THE COMPANY. I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAN IPS PRESIDENT, AND THEN ONLY WHEN IN WRONG AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING.
This form has been designed to strictly comply with State and Federal fair employment practice laws prohibiting employment discrimination. This Application for Employment Form is sold for general use throughout the United States. TOPS assumes no responsibility for the inclusion in said form of any questions which, when asked by the Employer of the Job Applicant, may violate State and/or Federal Law.
- Request for Driving Record
In accordance with the provision of section 604 and 607 of the fair credit reporting act, Law #91-508, I hereby certify that the information requested below will be used for a "permissible purpose" as defined in the Act, in that the information received will be used for no other purpose
Arenz Heating & Air Conditioning Corp
I hereby authorize the Neefus Stype Agency to release my complete driving record to the above-listed company. I release them from any and all liability that may result from furnishing such information.