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Last Name:
First Name:
Middle Name:
Street Address:
City:
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Zip:
Email:
Phone:
Cell Phone:
Secondary Contact:
Secondary Contact Email:
Secondary Contact Phone:
When are you available for work?
Desired Position:
Who Referred You?
Salary Desired:
Education History
Education Section 1
Name of institution:
Years Attended:
Major:
Degrees:
Education Section 2
Name of institution:
Years Attended:
Major:
Degrees:
Education Section 3
Name of institution:
Years Attended:
Major:
Degrees:
Employment Experience
Do you have a valid driver's license?
Yes
No
Are you employed now?
Yes
No
May we inquire of your present employer?
Yes
No
Job 1
Employer
Address:
Date From:
Date To:
Supervisor:
Reason for Leaving:
Starting Pay Rate:
Ending Pay Rate:
Work Performed:
Job 2
Employer
Address:
Date From:
Date To:
Supervisor:
Reason for Leaving:
Starting Pay Rate:
Ending Pay Rate:
Work Performed:
Job 3
Employer
Address:
Date From:
Date To:
Supervisor:
Reason for Leaving:
Starting Pay Rate:
Ending Pay Rate:
Work Performed:
Job 4
Employer
Address:
Date From:
Date To:
Supervisor:
Reason for Leaving:
Starting Pay Rate:
Ending Pay Rate:
Work Performed:
Skills (list the skills you have that support to the position you are applying for
General Information
Are you 18 years of age or older?
If under 18 years of age, applicant will be required to submit a birth certificate or work certificate as required by State or Federal Law.
Yes
No
Have you ever pleaded "guilty," "no contest" or been convicted of a crime?
Yes
No
If "Yes," when and where?
If "Yes," please provide details:
Type of employment desired:
Full Time
Part Time
What days of the week are you able to work? (please circle)
S
M
T
W
Th
F
S
Are you able to work overtime?
Yes
No
Are you able to have a flexible schedule for a last minute rescheduling if a shift is needed to be covered?
Yes
No
Are you able to work in the cold?
Yes
No
How were you referred to us?
I, the undersigned, certify that all the information on this application is true and complete to the best of my knowledge.
I also understand that employment at General Rental Center is “at will” and that the employer or the employee can terminate the employment relationship at any time for any or no reason, as long as the reason is not prohibited by law.
I also understand and grant permission to General Rental Center to conduct an investigation into my background and that an offer of employment may be contingent upon the satisfactory results of such an investigation.
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