EMO TRANS, INC. APPLICATION FOR EMPLOYMENT
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EMO TRANS, INC.
APPLICATION FOR EMPLOYMENT
EMO Trans, Inc. is an equal opportunity employer. EMO Trans, Inc. does not discriminate against
qualified applicants based upon any protected group status, including but not limited to race, color,
creed, religion, gender, national origin, citizenship status, ancestry, age, sexual orientation, marital
status, physical or mental disability, military status or any other protected Federal, state or local
status unrelated to the performance of the work involved.Please answer all questions completely.
PERSONAL INFORMATION Incomplete information could disqualify you from further consideration.
Full Name Date _______________________
Address ________________________________________________________________________
E-mail Address __________________________________________________________________
Home Phone #____________________________ Mobile Phone # _______________________
Are you eligible to work in the U.S? Yes No
Are you at least 18 years or older? (If no, you may be required to provide authorization to work.)
Yes No
Have you ever been terminated from employment or asked to resign by an employer?
Yes No If yes, please provide company names and details:
_______________________________________________________________________________
Do you have any relatives employed by this organization? ________________________________
Are you able to perform the essential functions of the job for which you are applying, with or without
a reasonable accommodation? Yes No
Have you ever been employed by EMO Trans, Inc. before? Yes No
If yes, gives dates, location and position: ______________________________________________
Are you fluent in any foreign language? Yes No
If yes, please indicate which language(s) and your proficiency (i.e., speaking, reading and/or writing):
______________________________________________________________________________
Will you now, or in the future, require sponsorship for employment (e.g. H-1B visa Status?
________________________________________________________________________________
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052015MILITARY INFORMATION
Have you ever served in the U.S. Armed Forces? Yes No
If yes, which branch? ______________________________________________________________
Describe any training received relevant to the position for which you are applying:
________________________________________________________________________________
EMPLOYMENT DESIRED
Date you can start ________________________ Hourly Rate/Salary desired _______________
Position desired __________________________________________________________________
Are you currently employed? Yes No
If so may we inquire of your present employer? Yes No
REFERRAL SOURCE
How did you hear about us? _________________________________________________________
Do you know anyone who works for our company? Yes No If yes, who? __________________
EDUCATION AND TRAINING
Name and Location No. of Years Degree Subjects
Education
of School Attended Received Studied/Major
High School Yes No
College or University Yes No
Trade, Business or Yes No
Correspondence School
Professional Certification, Training, or License Issuing Body Expiration Date
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052015EMPLOYMENT HISTORY
From To Employer Name Telephone
Job Title Address
Immediate supervisor and Summarize the nature of work performed and job
title: responsibilities:
Hourly Rate/Salary: Reason for leaving:
From To Employer Name Telephone
Job Title Address
Immediate supervisor and Summarize the nature of work performed and job
title: responsibilities:
Hourly Rate/Salary: Reason for leaving:
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052015EMPLOYMENT HISTORY cont.
From To Employer Name Telephone
Job Title Address
Immediate supervisor and Summarize the nature of work performed and job
title: responsibilities:
Hourly Rate/Salary: Reason for leaving:
Do you have any special skills, experience and/or training that would enhance your ability to perform
the position applied for? If yes, explain:
_______________________________________________________________________________
Computer Skills (please describe): ____________________________________________________
REFERENCES ve the names of three business references not related to you, whom you have
Years
Name Title Address, Phone, Email
Acquainted
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052015Please read carefully before signing.
I understand that neither the completion of this application nor any other part of my consideration for
employment establishes any obligation for EMO Trans, Inc. to hire me. I understand that if I am
hired, I will be an employee “at will” meaning I am not hired for any definite length of time and either I
or the organization can terminate my employment at any time for any or no reason, with or without
cause and without prior notice. I understand that no representative of EMO Trans, Inc. has the
authority to make any assurance to the contrary. I also understand that if I am hired, I will be
required to provide proof of identity and legal authorization to work in the United States and that
federal immigration laws require me to complete at I-9 form in this regard.
I understand that the organization may choose to obtain background information about me from a
consumer reporting agency. Before requesting a report from a consumer reporting agency, the
organization will ask for my authorization. I understand that if I refuse to provide such authorization,
my application for employment will not be considered.
If employed, I understand that as a condition of employment, I may be required to agree to and sign
the organization’s confidentiality, non-compete and/or other similar agreements that I may have
already signed with current and/or former employers. I expressly authorize, without reservation, the
employer, its representatives, employees or agents to contact and obtain information from all
references (personal and professional), employers, public agencies, licensing authorities and
educational institutions and to otherwise verify he accuracy of all information provided by me in this
application, resume or job interview. I hereby waive any and all rights and claims I may have
regarding the employer, its agents, employees or representatives, for seeking, gathering and using
truthful and non-defamatory information, in a lawful manner, in the employment process and all other
persons, corporations or organizations for furnishing such information about me.
I attest, to the best of my knowledge, with my signature below, that I have given to EMO Trans, Inc.
true and complete information on this application. No requested information has been concealed. If
any information I have provided is untrue, or if I have concealed material information, I understand
that this will constitute cause for the denial of employment or immediate dismissal.
Signature__________________________________ Date__________________________
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