9DOK
Call:
513-681-7373
E-mail:
[email protected]
Visit: 1738 Townsend St. Cincinnati, OH 45223
Call:
513-681-7373
|
E-mail:
[email protected]
|
Visit:
1738 Townsend Pl. Cincinnati, OH 45223
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Employment Application
Employment Application
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Application for Employment
All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring an accommodation to complete the application and/or interview process should contact a management representative.
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Packaging Machine Operator
Package Handler
Date of application
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Full name
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Last
Street address
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City
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Main phone number
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Alternate phone number
Email
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Employment Experience
Please list the names of your present or previous employers in chronological order with present or most recent employer listed first. Be sure to account for all periods of time. If self-employed, give firm name and supply business references. Add an additional page if necessary.
Name of Employer
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Supervisor
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May We Contact?
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Phone Number
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Dates Employed From
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Month
Day
Year
Dates Employed To
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Month
Day
Year
Job title and duties
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Reason for leaving
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Name of Employer
Supervisor
May We Contact?
Yes
No
Phone Number
Dates Employed From
Month
Day
Year
Dates Employed To
Month
Day
Year
Job title and duties
Reason for leaving
Name of Employer
Supervisor
May We Contact?
Yes
No
Phone number
Dates Employed From
Month
Day
Year
Dates Employed To
Month
Day
Year
Job title and duties
Reason for leaving
Have you ever been involuntarily terminated or asked to resign from any job?
Yes
No
If yes, please explain
Please explain any gaps in your employment history
Please list any other experience, job-related skills, additional languages, or other qualifications that you believe should be considered in evaluating your qualifications for employment
Education
Please describe your educational background in the table provided below.
Education
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School name
Years completed
Diploma/Degree (Yes/No)
Area of study/major
Specialized training, skills, or extracurricular activities
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Business and Professional References
Please list three professional references of individuals who are not related to you. Personal references are acceptable as long as they are unrelated to you.
Business and Professional References
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Name and title
Relationship
Years Known
Phone Number
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General Information
Are you related to a current employee of Bernard Laboratories? If yes, please state their name and your relationship to them below
How did you find out about this position?
Applicant Statement and Agreement
Please read and initial each paragraph below. If there is anything that you do not understand, please ask.
I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.
(Required)
In the event of my employment with the company, I understand that I am required to comply with all rules and regulations of the company.
(Required)
If hired, I understand and agree that my employment with the company is at-will and that neither I nor the company is required to continue the employment relationship for any specific term. I further understand that the company or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.
(Required)
I understand that the safety of employees is extremely important to the company and that the company is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.
(Required)
I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
(Required)
I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration law requires me to complete an I-9 Form in this regard.
(Required)
I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed, and the remainder of this Agreement shall be enforceable.
(Required)
I understand and agree that I may be required to take a drug and/or alcohol test as a condition of hiring or continued employment. I agree to consent to take such test(s) at such time as designated by the Company and to release the Company, its directors, officers, agents, or employees from any claim arising in connection with the use of such test(s).
(Required)
My signature attests to the fact that I have read, understand, and agree to all of the above terms.
Name
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Date
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Month
Day
Year
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