An Affirmative Action/Equal Opportunity Employer
Online Application for Employment
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Personal Information
First name:
Middle name:
Last name:
SSN:
Street Address:
Apt number:
City:
State:
Zip Code:
Email:
Phone:
alt Phone:
Are you eligible to work in the U.S.?
Yes
No
Were you previously employed by HSC?
Yes
No
Have you ever been convicted of a crime other than a minor traffic violation?
Yes
No
If yes, please explain. Conviction is not absolute bar from employment.
Do you have any relatives employed by HSC?
Yes
No
If yes, Who?
What position(s) are you applying for
Laborer:
Yes
No
Sign Shop:
Yes
No
Office:
Yes
No
Traffic Control:
Yes
No
Other:
Date available to start:
How did you hear about this job?
Newspaper
Referred by employee
Agency
Internet
Other
Education:
High School:
City, State:
Years Completed:
Diploma/GED:
yes
no
College or University:
City, State:
Years Completed:
Degree Earned:
Major:
Trade/Business School:
City, State:
Years Completed:
Degree Earned:
Major:
Other Education:
City, State:
Years Completed:
Degree Earned:
Major:
Professional Registration, Certification or Licenses
Current Licenses:
License:
State:
Lic Num:
Lic Year:
Expiration:
License:
State:
Lic Num:
Lic Year:
Expiration:
Work Experience
Present or Most Recent Employer
Phone:
Address:
Start Date:
Starting Salary:
Statrting Position:
First Supervisor:
Termination Date:
Last Salary
Last Position
Last Supervisor:
Reason for leaving:
Duties:
Previous Employer
Phone:
Address:
Start Date:
Starting Salary:
Statrting Position:
First Supervisor:
Termination Date:
Last Salary
Last Position
Last Supervisor:
Reason for leaving:
Duties:
Previous Employer
Phone:
Address:
Start Date:
Starting Salary:
Statrting Position:
First Supervisor:
Termination Date:
Last Salary
Last Position
Last Supervisor:
Reason for leaving:
Duties:
Previous Employer
Phone:
Address:
Start Date:
Starting Salary:
Statrting Position:
First Supervisor:
Termination Date:
Last Salary
Last Position
Last Supervisor:
Reason for leaving:
Duties:
READ CAREFULLY BEFORE SUBMITTING
I certify that the answers given and statements made by me on this application or resume submitted are true and accurate, to the best of my knowledge and belief. I understand that any misleading or false statements, and any omissions or alterations to the working of this application made by me, may render this application void and if I am employed, this would lead to termination. I understand that Highway Supply, LLC is committed to providing a drug free work environment for its employees; I consent to a drug test as a condition of employment or continued employment. I understand that I may not work in a position if it is determined that I pose a "direct threat" to the health or safety of myself or others.
I further understand that if I am employed,
no oral representations and/or promises will supercede written policies.
This Application for Employment does not constitute a contract for employment; my employment may be terminated at any time by either myself or Highway Supply, LLC with or without cause or reason, and with or without notice.
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