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SDRC Employment Application

(Pre-employment questionnaire) (An Equal Opportunity Employer)

Personal Information

Are you prevented from lawfully becoming employed in this country because of visa or immigration status: 

Yes  

No  

Are you 18 years or older: 

Yes  

No  

Employment Desired

Are you employed now? 

Yes  

No  

If so, may we inquire of your present employer? 

Yes  

No  

Have you ever applied to this company before?  

Yes  

No  

Education

Education Name & Location of School # of years attended Did you graduate? Subjects Studied
Grammar School
High School
College
Trade or Business School

General

Former Employer

List below last four employers, starting with last one first.
From To Name & Address of Employer Salary Position Reason for Leaving

References

Give the names of three persons not related to you, whom you have known at least one year.
Name Telephone Business Years Acquainted
1
2
3

Acknowledgement

*I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at anytime, at either my or the company's option. I also understand and agree that the terms and condition of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into an agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.*