Select
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Class A Driver
Class B Driver
Mechanic
Equipment Operator
Compactor Technician
Sales Position
Office Position
Check One
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Full Time
Part Time
Name
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First Name
Last Name
Date of Birth
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MM
DD
YYYY
Phone Number
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(###)
###
####
Email Address
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Highest Level of Education:
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Major & Degree
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Number of Years Completed
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Have you ever been convicted of a crime?
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Yes
No
If yes, explain number of conviction(s), nature of offense(s), leading to conviction(s), how recently such offense(s), was.were committed, sentence(s) imposed, and type(s) of rehabilitation.
Please list two references other than relatives or previous employers. Include Name, number, position, company and address
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Job Title:
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Address
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Start Date:
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MM
DD
YYYY
End Date:
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MM
DD
YYYY
Name of last Supervisor
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Reason for Leaving:
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List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
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Name of Employer
Job Title
Address
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Pay or Salary
Name of Last Supervisor
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Reason for Leaving:
Name of Employer
Job Title
Address
Start Date
MM
DD
YYYY
End Date
MM
DD
YYYY
Name of Last Supervisor
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Reason for Leaving:
Did you complete this application yourself?
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Yes
No
If no, Who did?
May we contact your present employer?
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Yes
No
Check the following boxes:
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I certify that all answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.
I authorize Waste Haulers to contact my previous employers in reference to this application.
I agree that upon completing this application that I am willing to complete a pre-employment drug screening.