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EMPLOYMENT
APPLICATION
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Full Name
*
First
Last
Street Address
City
State/Province/Region
Postal/Zip Code
Phone Number
Email
*
Are there other names under which you have worked or attended school?
*
Yes
No
If yes, please list for reference checking purposes.
Are you at least 18 years old? (If not, your employment will be subject to verification that meet state/federal minimum age requirements for the type of work you are applying for and have obtained valid work permit.)
*
Yes
No
Have you ever been convicted of a crime or pleaded no contest for an offense or violation other than minor traffic violations?
*
Yes
No
If yes, explain 1.) Nature of crime, 2.) Date of conviction, 3.) State in which convicted. Convictions are not an automatic bar to employment.
Have you ever applied at this company before?
*
Yes
No
Have you ever worked for this company before?
*
Yes
No
If yes, when?
Position Applying For (**not all jobs in this drop down menu are necessarily available at current time**)
*
Truss Assembler (Richco)
Building Component Technician I (Richco)
Truck Driver - Local (Richco)
Material Handler/Assembler/Sanding/Utility (Richardson Contract Furniture)
CNC Operator (Richardson Contract Furniture)
Other
Full-time or Part-time?
*
Full-time
Part-time
Salary/Hourly Preference
Shift Preference (not applicable to every position/location)
*
1st Shift
2nd Shift
3rd Shift
When can you start?
*
MM-DD-YYYY
How were you referred to us?
*
Agency
Facebook
Online
Newspaper
Walk-In
School
Friend/Relative
Other
If relevant, please describe word processing speed, software knowledge, and office equipment experience.
If relevant, please describe experience using manufacturing machines and equipment.
High School
(name, city, state)
Diploma or degree received?
Yes
No
College
(name, city, state)
Diploma or degree received?
Yes
No
Graduate School
(name, city, state)
Diploma or degree received?
Yes
No
Drivers License Number
What state was your Drivers License issued in?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Deleware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louissiana
Maine
Maryland
Massachusettes
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Drivers License Expiration Date
MM-DD-YYYY
Employment History - Name of Employer
Address
(city, state, zip code)
Phone Number
Job Title
Employment Dates
(mm/yy - mm-yy)
Name of Immediate Supervisor
(first and last)
Description of Duties
Salary/Hourly Start
What was your starting salary at your previous employer?
Salary/Hourly End
Reason for leaving
If currently employed, may we contact as a reference?
Yes
No
Additional Employment History - Name of Employer
Address
(city, state, zip code)
Phone Number
Job Title
Employment Dates
(mm/yy - mm/yy)
Name of Immediate Supervisor
(first and last)
Description of Duties
Salary/Hourly Start
What was your wage/salary when you started the job?
Salary/Hourly End
Reason for leaving
If currently employed, may we contact as a reference?
Yes
No
Employment Reference 1
*
First
Last
Phone Number
Address
(address, city, state, zip code)
Relationship
What is your relationship to 1st Employee Reference?
How long have you known them?
Employment Reference 2
*
First
Last
Phone Number
Address
(address, city, state, zip code)
Relationship
What is your relationship to 2nd Employee Reference?
How long have you known them?
Employee Reference 3
*
First
Last
Phone Number
Address
(address, city, state, zip code)
Relationship
What is your relationship to 3rd Employee Reference?
How long have you known them?
All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denials of employment or be cause for subsequent dismissal if I am hired. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining me or my employment. I understand that upon receiving a job offer, a physical examination and drug screening may be required. (Note: If this is a job requirement, you will be notified.) Regardless of wheter or not I become employed by the company, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company's, unless specifically provided otherwise in a written employment contract. I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer or official of the company, and then only means of a signed, written document. I agree to all above listed terms and conditions.
*
Yes
By consenting to this privacy notice, you are giving us permission to process the personal data that you provide us with specifically for recruitment/hiring process. This organization is committed to being transparent about how it collects and uses that data and meeting its data protection obligations. We may collect this information in a variety of ways. For example, in application forms, CVs or resumes, obtained from any identity documents, or collected through interviews or other forms of assessment. We may collect personal data about you from third parties, such as references supplied by former employers. Data will be stored in a range of different places, including on your application record, in HR management systems, and other IT systems (including email). We take the security of your data seriously. We have internal policies and controls in place to ensure that your data is not lost, accidentally destroyed, misused, or disclosed, and is not accessed except by our employees in the proper performance of their duties. If your application of employment is unsuccessful, the organization will hold your data on file for six months after the end of the relevant recruitment process. If you agree to allow us to keep your personal data on file, we will hold your data on file for a further six months for consideration for future employment opportunities. At the end of that period, or once you withdraw your consent, your data is deleted and destroyed. If your application for employment is successful, personal data gathered during the recruitment process will be transferred to your Human Resources file (electronic and paper based) and retained during your employment. You are under no statutory or contractual obligation to provide data to Richardson Industries, Inc. during the recruitment process. However, if you do not provide the information, we may not be able to process your application properly or at all.
*
I understand.
Submit
