EDCO: Family Owned – Locally Operated

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Employment Application

* fields are required. If any areas do not apply please state Not Applicable in the field.

Applicant Information

*First Name

Middle Initial

*Last Name

*Date Submitted

*Street Address

Apartment / Unit #

*City

*State

*Zip

*Phone

*Email

How long have you resided at this address?

*Date Available?

Position Applied for

Have you ever worked for this company?
Yes No


If so, under what name?

*Do you have a valid CA Driver's license?
Yes No


*Driver's license category

*Driver's license number

*Driver's license expires

Do you speak more than one language?
Yes No


List languages

Person to notify in case of an emergency?

*Name

*Address

*Phone

Education

High School

Name

Address

Did you graduate?
Yes No


Degree

College

Name

Address

Did you graduate?
Yes No


Degree

Other Education

Name

Address

Did you graduate?
Yes No


Degree

Special Training

List any training you have had which may help to qualify you for the position for which you are applying. Include trade, military, etc. Indicate type of training, where acquired, dates and whether you completed it successfully.

 

References

Please list three professional references.

Reference 1

Full Name

Relationship

Company

Phone

Address

Reference 2

Full Name

Relationship

Company

Phone

Address

Reference 3

Full Name

Relationship

Company

Phone

Address

Previous Employment

Company 1

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes No


Company 2

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes No


Company 3

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes No


Military Service

Branch

Rank at discharge

Are you currently a member of National Guard or Reserve:
Yes No


Working Capability

Any job offer which may be made may require or be made contingent upon you being able to pass a physical examination.

*Are you over 18 years of age?:
Yes No


Can you submit a work permit if under age 18?:
Yes No


*Are you authorized to work lawfully in the US?:
Yes No


*Can you provide proof after you are hired that you can work lawfully in the US ( If hired, you will be required to provide documentation)?:
Yes No


Disclaimer and Signature

I certify that all information contained in this application for employment is true and complete. Any incorrect or misleading statement(s) will render this application void. I understand that this application will remain in effect for 90 days from the date it is submitted. I must renew my application to be considered for other job openings after 90 days. I understand that completion of this application does not constitute an offer or promise of employment. I authorize the Company to contact my references and former employers listed above and understand that, as a condition of employment, the Company will require completion of a drug screen and background check at the company's expense, in compliance with the Company's pre-employment screening policies. I have or will provide a background investigation release form which contains the disclosures under the Fair Credit Reporting Act and my authorization and general release to conduct the screening under the FCRA, which I have read/will read before signing.

In the event that I am hired for a position, I shall comply with all Company policies and procedures. I understand and agree that any misrepresentation, omission or false statement that I make in this application will be sufficient cause for the Company to withdraw any offer of employment and/ or terminate my employment.

If hired, I understand that I will be an at-will employee, meaning my employment can be terminated by me or the Company at any time and for any reason, or for no reason.

*Signature:

Resume (if applicable)

Attach your resume: