There are no positions available at this time Open Form Employment Application Personal Information Name * First Name Last Name Date of Birth * MM DD YYYY Social Security Number * Present Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How many yeas at this address? * Phone * (###) ### #### Email * Position applied for? * Hours needed? * Please select: Full Time Part Time Temporary Part Time Summer Only Part Time Seasonal Rate of pay required? * $ Education Highschool: Highest Completed Grade * Please select: 5 6 7 8 9 10 11 12 Name of High School * Address of High School Address 1 Address 2 City State/Province Zip/Postal Code Country Last Year Attended * Graduated * Please select: Yes No Grades * Please Select: Above Average Average Below Average If NOT a high school graduate, do you have an equivalency? * Please select: N/A Yes No College Please Select: N/A 1 2 3 4 5 6 Name of college Address of college Address 1 Address 2 City State/Province Zip/Postal Code Country Last year attended Graduated? Please Select: N/A Yes No Course of Study Grades Please Select: N/A Above Average Average Below Average What special vocational or business courses have you take? Select the job skills you've acquired and what equipment you can operate. * Mechanical Electrical Building Construction Plumbing Hardware Cabinets Millwork Sales Building Supply Customer Service Dispatch Truck Maintenance Security Drafting Blueprint Commercial Art Bookkeeping Lumber - Grading Truck Driver Cash Register Typewriter Key Punch Computer Word - Processing Calculator Drill Press Arc Welder Radial Arm Saw Component Saw Other Work History List in order, last or present employer first. Employment record should include the last five years. If you were or are a student or have been retired within the past ten years, please indicate. Name of employer Employer Phone Number Address of employer Address 1 Address 2 City State/Province Zip/Postal Code Country Start Date MM DD YYYY End Date MM DD YYYY Rate of pay @ start $ Rate of pay @ end $ Describe in detail the work performed: May we contact this employer Yes No Name of employer Employer Phone Number Address of employer Address 1 Address 2 City State/Province Zip/Postal Code Country Start Date MM DD YYYY End Date MM DD YYYY Rate of pay @ start $ Rate of pay @ end $ Describe in detail the work performed: May we contact this employer Yes No Name of employer Employer Phone Number Address of employer Address 1 Address 2 City State/Province Zip/Postal Code Country Start Date MM DD YYYY End Date MM DD YYYY Rate of pay @ start $ Rate of pay @ end $ Describe in detail the work performed: May we contact this employer Yes No To the applicant Employment is subject to verification that you are of minimum legal age. Are you 18 years of age or older? * Yes No Are you a United States citizen? * Yes No If not a citizen of the U.S. can you provide proof that you can legally be employed in the United States? * Please Select: N/A Yes No What languages can you read, write, and speak fluently? * Emergency Contact Name * Emergency Contact Relationship * Emergency Contact Phone Number * Emergency Contact Address Address 1 Address 2 City State/Province Zip/Postal Code Country Will you abide by the safety rules of this company? * Please Select: Yes No If hired, do you have reliable transportation? * Please Select: Yes No Have you ever been discharged or asked to resign? * Please Select: No Yes If you answered yes, please explain. Have you ever been convicted of a felony or misdemeanor excluding traffic violations for which a fine of $50.00 or less was imposed upon you? * Please Select: No Yes If you answered yes, please explain. Have you ever been refused bond by an employer? * Please Select: No Yes Have you ever been discharged for poor or improper record keeping? * Please Select: No Yes Have there ever been shortages or misunderstandings about merchandise or funds at a place of employment involving you? * Please Select: No Yes If you answered yes, please explain. Certification * I agree to undergo a character and credit investigation at company expense and understand that this inquiry will include but will not be limited to personal interviews with third parties such as family members, business associates, financial and credit sources, etc. Further, I hereby release my former employers and other character and credit sources from liability or damages on account of having furnished information regarding my personal character, habits, work record, credit history, etc. I agree to take alcohol/drug examination and other examination for pre-employment as well during the course of my employment. I understand the examinations will be at the expense of the company, and that they are a condition of employment. I understand and agree that my initial employment with this Company shall be probationary. I further understand that employment during the probationary period is in no way a guarantee of employment thereafter. Furthermore, I understand that if following my probation my employment is continued, the employment relationship is at will and may be terminated by either party at any time. If accepted for employment, I hereby agree to abide by all the rules and policies of the Company as explained from time to time and to wear all personal protective equipment required for the occupation in which I am engaged. I agree to provide additional medical information which may be required or to take a medical or any other type of examination at the expense of the company necessary to qualify or retain employment with the company. I fully understand that if I fail to answer, falsify the answer, or enter misleading answers to any question or fail to provide information which might make any of my answers on the application misleading, that this alone may result in a refusal to hire or my termination if I am hired and I hereby agree that the Company shall not be liable in any respect if my employment is terminated or if I am not hired for this reason. I further understand the employer makes no guarantees, either written or implied as to the number of work days or work hours provided to any employee. The total number of work hours provided to each employee during a pay period is solely contingent on the employers business activity and needs. I Agree Please briefly explain why you desire to work for us and why you would make a good employee. * I voluntarily authorize MANHATTAN MANAGEMENT CO., LLC to which I am applying for employment, to conduct a thorough investigation of my educational, professional, conviction, employment records, driving records and credit history concerning my residence, character, reputation, personal characteristics, mode of living, education, employment and habits to determine my acceptability for hiring or continued partners of each of the foregoing, and any person, company or corporation providing information pursuant to this release from any and all claims and causes of action in law or equity, including any and all damages which I might have or incur as a result of any investigation conducted pursuant to this authorization. I certify that I have read and understand each of the statements and Authorizations contained in and throughout this Authorization for background investigation and Release of Liability, and sign this document as my free and voluntary act. * I Agree Date of Application Submission * MM DD YYYY Date of Birth * MM DD YYYY Applicants full legal name. * Social Security Number * Driver's License Number * State * Last Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Electronic Signatures: The parties acknowledge and agree that this agreement and all other agreements and documents related to the employment application may be executed by electronic signature, which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature. Without limitation, “electronic signature” shall include faxed versions of an original signature or electronically scanned and transmitted versions (e.g. via pdf) of an original signature. * I Agree Thank you for submitting your application!
