Application For Employment
All applicants will be considered for employment without regard to race, religion, color, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other status protected by law. We are an Equal Opportunity Employer.
       
    Date:
Personal Information
       
Last Name:    
First Name:    
Middle:    
       
Address: Primary Telephone:
City: Alternate Telephone:
State:    
ZIP:    
       
Referred By: Paper or Radio Advertising: College Campus
  Employment Agency: Company Web Site
  Friend/Relative-Who? Name: Walk-in
      Other
       
Are you over 16 years of age? Yes No  
Are you legally eligible for permanent employment in the U.S.? (If hired, verification will be required by law).
Position(s) applied for: Full TimePart Time
       
Schedule: Fill in hours available for work (not just preference), indicate AM or PM.
Monday Tuesday Wednesday Thursday Friday Saturday
           
       
Date you are available to start work:  
Salary or Wages desired: $ Per Hour Per Week
Have you worked for us before? Yes No
*If "Yes", when: Terril Royal
       
Indicate special qualifications or skills:
Have you ever been convicted of a crime (excluding misdemeanors and traffic offenses)? Yes No
If "Yes", list convictions: (A conviction does not necessarily disqualify an applicant for the position being applied for).
       
Education Information
 
Name & Location of School Course of Study/Degree Years Completed Did You Graduate?
Elementary:
High School:
College:
Other:
       
Military Service
       
Branch of Service From To Rank & Duties Date Discharged
       
Employment History (start with most recent employer)
       
Employer: Dates Employed: From: To:
Phone Number: Supervisor's Name:
Address: Starting Salary/Wage:
City: Ending Salary/Wage:
State: Job Title:
ZIP: Reason for Leaving:
Duties:
Employer: Dates Employed: From: To:
Phone Number: Supervisor's Name:
Address: Starting Salary/Wage:
City: Ending Salary/Wage:
State: Job Title:
ZIP: Reason for Leaving:
Duties:
Employer: Dates Employed: From: To:
Phone Number: Supervisor's Name:
Address: Starting Salary/Wage:
City: Ending Salary/Wage:
State: Job Title:
ZIP: Reason for Leaving:
Duties:
       
Are you currently employed? Yes No      If hired, will you work overtime if required? Yes No
Total of hours you would like to work each week? Min Max
Do you plan, or are you working with someone else while working for us? Yes No
  For Whom? When? Where?
       
Personal References
       
Name Address Years Known Telephone
       
       
The information presented here is true and complete to the best of my knowledge. Should I be employed by the Company, any
misrepresentation or false statement contained herein may be considered cause for possible dismissal. The Company has my permission to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment; personal history or credit standing and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice to me. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to the Company.
I understand this application does not constitute an employment contract of any kind. Should I be employed by the Company, I may resign such employment at any time at my discretion with or without prior notice and the Company may terminate my employment at any time at their discretion, with or without cause and with or without prior notice.
Date: Type Full Name:
       

 

Cadre Teleservices
107 South State Street
Terril, IA  51364
Phone: (712) 853-6298
or toll-free 1-800-275-2485

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