S.C. SWIDERSKI JOB APPLICATION

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Name *
Name
Address *
Address
Phone *
Phone
Are you 18 years of age older? *
If applying for a position that requires a CDL, are you 21 years of age or older? *
CDL License Holder? *
Are you either a U.S. citizen or an alien authorized to work in the U.S.? *
POSITION DESIRED
Have you worked with SC. Swiderski previously? *
EDUCATION
Please provide the name of the school you attended, the year you graduated and your course of study. If other, please provide training and special skills.
SKILLS
Are you experienced in using a personal computer? *
Are you able to stand, stoop, bend, squat and/or sit for an extended amount of time? *
Are youable to lift up to 90 pounds with or without assistance? *
WORK EXPERIENCE
Please list all previous employment for the past ten years, beginning with the most recent.
From - To or Current
May we contact his employer? *
May we contact this employer? *
May we contact his employer? *
REFERENCES
Identify three persons who know your work, beginning with the most recent.
Phone number *
Phone number
Phone number *
Phone number
Phone number *
Phone number
If it is a employee referral please indicate which employee.
I affirm that the information I have provided in this application is true to the best of my knowledge, information and belief, and I have not knowingly withheld any information requested. I understand that withholding or misstating any information requested in this application is grounds for rejection of my application, and that providing false or misleading information in this application is grounds for discharge. I authorize the company to verify my references, record of employment, education record, and any other information I have provided. Unless otherwise noted, I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to such inquiry or disclosure. Please sign name below if you agree to the above.