Employment Application

Applications are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.

Personal Information:

Position Applying For

Date of Application

Source of Job Opening

Name

Address

City

State

Zip

Phone Number

Email


Have you ever been convicted of or charged with a felony or misdemeanor?
 Yes No

If yes, please explain in full, including dates, details of offense(s) charged, jurisdiction and disposition of case


Have you, or any person or entity with whom you have been associated with, filed for bankruptcy, been declared bankrupt or insolvent, or been the subject of any receivership proceedings within the last 7 years?
 Yes No

If yes, please explain in full, including dates, amounts involved and disposition


Additional Employment:

If hired, while employed by Turney Services, will you be employed by, working for, or compensated by any other business, firm, company, or entity?
 Yes No

If yes, please state the nature of the employment.


Education:

Schools/Colleges Attended



# Years



Year Graduated



Degree




Professional License(s) Held:


Special Skills

Describe any special skills or qualifications for this position


Employment/Work Experience:
Start with your present or most recent position. Include military service assignments and volunteer activities. Exclude names of organizations that would indicate race, color, religion, sex, or national origin.

Date of Employment
From:
To:

Employer

Yearly Salary or Hourly Wage

Job Title

Employer Address (Including city state and zip code)

Employer Telephone

Description of Duties/Responsibilites:

Reason for Leaving:

Employer 2 (If Applicable)

Date of Employment
From: To:

Employer

Yearly Salary or Hourly Wage

Job Title

Employer Address (Including city state and zip code)

Employer Telephone

Description of Duties/Responsibilites:

Reason for Leaving:

Employer 3 (If Applicable)

Date of Employment
From: To:

Employer

Yearly Salary or Hourly Wage

Job Title

Employer Address (Including city state and zip code)

Employer Telephone

Description of Duties/Responsibilites:

Reason for Leaving:

Employer 4 (If Applicable)

Date of Employment
From: To:

Employer

Yearly Salary or Hourly Wage

Job Title

Employer Address (Including city state and zip code)

Employer Telephone

Description of Duties/Responsibilites:

Reason for Leaving:


Personal References
Please provide names, addresses, phone numbers, relationship and how long you’ve known each reference.

Reference 1

Name

Address (Including city state and zip code)

Phone

Relationship

How Long?

Reference 2

Name

Address (Including city state and zip code)

Phone

Relationship

How Long?

Reference 3

Name

Address (Including city state and zip code)

Phone

Relationship

How Long?


I CERTIFY that the above answers are true and complete to the best of my knowledge. I authorize Turney Services to investigate any statement contained in this application, and to obtain a credit report on me as necessary to determine my qualifications. I understand that this application is not and is not intended to be any kind of contract or agreement. In the event of employment, I understand that any false or misleading information given in my application, correspondence, discussions, or interview may result in immediate termination. I understand also, that I am required to abide by all rules, regulations, and policies of Turney Services.

Please type your name for your signature

Date of Application Signature


NOTIFICATION OF DRUG TESTING:
I, the undersigned, if hired by Turney Services, give consent to drug testing by a state approved testing firm on behalf of Turney Services.

Please type your name for your signature

Date of Application Signature (Drug Testing)