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Personal Information
Driving Experience
ACCIDENTS AND CONVICTIONS
ACCIDENT RECORD FOR PAST 3 YEARS OR MORE AND TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS)
EMPLOYMENT AS A D.O.T. DRIVER
EMPLOYMENT AS A D.O.T. DRIVER FOR THE PAST 10 YEARS
(In compliance with Commercial Motor Vehicle Safety Act of 1986)
Education History
EMPLOYMENT AT WILL STATEMENT
EMPLOYMENT AT ACME BRICK IS EMPLOYMENT AT WILL. Employment may be terminated for any reason, with or without cause or notice, at any time by the employee or the Company. Nothing in this application or any document or statement, oral or written, shall limit the right of the employer or the Company to terminate employment.
APPLICANT: PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING
I declare my answers to the questions contained herein are true to the best of my knowledge. I understand that if hired, I will be considered a provisional employee for 90 days from the date of my employment begins and I will be evaluated according to my job performance. I am aware that during my period of employment I will be subject to random alcohol and drug testing as required by the DOT as well as required by the Company’s Drug Free Workplace Policy. It is understood that any false statements or omission of information on the application will be sufficient reason for immediate rejection of my application for employment, or if employed, immediate termination. I hereby release Acme Brick Company and it’s Subsidiaries from all liability whatsoever that may arise from verifying the information contained herein. Upon written request, additional information as to the nature and scope of any required report, if one is made, will be available. I agree to abide by all rules and policies of the Company. I further agree to submit to any required physical examination by a doctor, as required by the Company. I also agree that, if employed, and then later leave employment with the Company, I agree to allow the Company to supply an employee reference about me including my dates of employment, job classification, time in each position, demotions, promotions, record of attendance and salary. I give Acme Brick Company and its Subsidiaries permission to check my references regarding past employment, education, personal references, motor vehicle records, and any criminal records.
Candidate Sign Off
EMPLOYMENT AT ACME BRICK COMPANY IS EMPLOYMENT AT WILL.
Employment may be terminated for any reason, with or without cause or notice, at any time by the employee or the Company. Nothing is this application or any Company document or statement, oral or written, shall limit the right of the employee or the Company to terminate employment.
In accordance with Acme Brick Company policy, any offer extended will be contingent upon the successful completion of a background check and drug screen.
Application Review