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Employment Application

Note: All fields must be answered fully in order to be considered for employment. Please ask for assistance if any portion of application is unclear.

PERSONAL INFORMATION:
Last Name:

 First Name:

 EMail Address:
 Work Phone No.:
()
Home Phone No.:
()
Street Address:

 City:

 State:

 Zip:

Referral Service:

Other:

 List any other last names you've had:

 Are you at least 18 years old?:
Yes No
Social Security:

Are you available to work any shift?:
Yes No
 Shift Preference:
Former Hays International Mailing employee?:
Yes No
 Job Title & Duties:

 Employment Dates:
to
Do you have:
A valid driver's license?:
Yes No

A Class-A chauffeur's license?:
Yes No
Positions applying for:
Operator
Stockhandler
Warehouse
Mechanic
Maintenance
Other:

Full Time
Part Time
Temporary
Weekend
Hand Work
EDUCATIONAL HISTORY:

High School:

Located:


 Dates Attended:

to

 Last grade completed, diploma, or degree:

 Course of study:


Trade School:

Located:


 Dates Attended:

to

 Last grade completed, diploma, or degree:

 Course of study:


College:

Located:


 Dates Attended:

to

 Last grade completed, diploma, or degree:

 Course of study:


Other:

Located:


 Dates Attended:

to

 Last grade completed, diploma, or degree:

 Course of study:

Use this space for comments about your special abilities. ie. Apprenticeships, tools, certifications, experience, etc.:

EMPLOYMENT HISTORY:
List work experience, starting with your present or last job. Include military and volunteer service. Omit activities which indicate race, color, religion, gender, national origin, disability, or any protected status. All other experience must be listed in order.
Job 1 - Contact this employer.
Name of Employer:

Address:

Phone:
()
Dates
Employed:
to

Wage Rate
Start/Finish:

 Job Title/Duties:

 Reason for Leaving:

Supervisor's Name:

Job 2 - Contact this employer.
Name of Employer:

Address:

Phone:
()
Dates
Employed:
to

Wage Rate
Start/Finish:

 Job Title/Duties:

 Reason for Leaving:

Supervisor's Name:

Job 3 - Contact this employer.
Name of Employer:

Address:

Phone:
()
Dates
Employed:
to

Wage Rate
Start/Finish:

 Job Title/Duties:

 Reason for Leaving:

Supervisor's Name:

Job 4 - Contact this employer.
Name of Employer:

Address:

Phone:
()
Dates
Employed:
to

Wage Rate
Start/Finish:

 Job Title/Duties:

 Reason for Leaving:

Supervisor's Name:

WORK REFERENCES:
Give work references that we may contact. (Include at least two most recent or current supervisors)
Reference 1
 Reference 2
Name:

Address:

Occupation:

Phone:
()
Name:

Address:

Occupation:

Phone:
()
Reference 3
 Reference 4
Name:

Address:

Occupation:

Phone:
()
Name:

Address:

Occupation:

Phone:
()
STATEMENT
    It is the policy of Hays International Mailing Services to provide equal employment opportunity for all individuals, regardless of race, color, national origin, disability, religion, sex, or age. Also, it is the company's policy to comply with all state and local laws, rules, and regulations pertaining to equal employment opportunities where the company conducts business.

    References will be contacted by Hays International Mailing Services at it's discretion. Permission to verify information on this application may be requested by Hays International Mailing Services. Misrepresentation may constitute terms for dismissal. Employment may be terminated by the employee or by Hays International Mailing Services with or without cause and with or without notice. Upon a conditional offer of employent, applicants must submit to a pre-employment drug test.




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