DMC Logistics

Employment Application

We are an equal opportunity employer, dedicated to a policy of non-discrimination on any basis including sex, race, color, religion, national origin, age, disability, orother characteristics protected under applicable law.

Position(s) Applied For:
Salary Desired:
How Did You Learn About Us? (Check One):
If "Other", please explain:
First Name:
Middle Name:
Last Name:
Present Address:
City:
State:
Zip:
Permanent Address:
City:
State:
Zip:
Telephone Number:
PLEASE SELECT "YES" OR "NO"

Have you ever filed an application with us before? Yes No
If yes, pelase give date:
Have you ever been employed with us before? Yes No
If yes, pelase give date:
Are you currently employed? Yes No
If yes, may we contact your present employer? Yes No
Do you have the legal right to work in the United States? Proof of citizenship or immigration status will be required upon employment. Yes No
On what date would you be available for work? *
Are you available to work:
Full Time Part Time Shift Work Temporary

Are any relatives employed with us? Yes No
Can you travel if a job required? Yes No
Have you been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment. Each one is considered in relation to the position applied for) Yes No
If yes, please explain:
Please indicate any foreign language you can speak, read or write fluently:
Have you ever served in the US Military? Yes No
If yes, what branch?
Do you have any special military training that is job-related? Yes No
If yes, please explain:
EMPLOYMENT EXPERIENCE

Employer (Most Recent):
Dates Employed:
Address:
City:
State:
Zip:
Telephone Number:
Hourly Rate/Salary Starting:
Hourly Rate/Salary Final:
Job Title or Position:
Supervisor:
Reason for Leaving:
Description of Duties:

Employer (Second Most Recent):
Dates Employed:
Address:
City:
State:
Zip:
Telephone Number:
Hourly Rate/Salary Starting:
Hourly Rate/Salary Final:
Job Title or Position:
Supervisor:
Reason for Leaving:
Description of Duties:

Employer (Third Most Recent):
Dates Employed:
Address:
City:
State:
Zip:
Telephone Number:
Hourly Rate/Salary Starting:
Hourly Rate/Salary Final:
Job Title or Position:
Supervisor:
Reason for Leaving:
Description of Duties:

If there have been any gaps in your employment during the last five years, please provide details in the space provided here:
List professional, trade, business or civic activities and offices held. Describe any specialized training, apprenticeship, skills and extra curriculum activities (excluding those, which, by their name or character, indicate the race, color, religion, sex, age, national origin, marital status, ancestry or handicap.)
Summarize special training skills (Such as machines, typing, PC skills, language skills, etc.), which you feel may especially qualify you for working with our company.

EDUCATION
High School
Name & Address of School
Years Completed:
Graduate (Yes or No)
Course of Study
Degree
Undergraduate College
Name & Address of School
Years Completed:
Graduate (Yes or No)
Course of Study
Degree
Graduate Professional or Other
Name & Address of School
Years Completed:
Graduate (Yes or No)
Course of Study
Degree

ADDITIONAL INFORMATION
Please list three people who are not related to you and who are not previous supervisors, whom you have known for at least one year and whom we may contact as additional references.
Reference Name:
Relationship:
Company:
Years Known:
Address:
Telephone Number:

Reference Name:
Relationship:
Company:
Years Known:
Address:
Telephone Number:

Reference Name:
Relationship:
Company:
Years Known:
Address:
Telephone Number:

RESUME
If you would like to include your resume with this application, please do so:

APPLICANT'S STATEMENT

I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application or any interview is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered. Please note that all information is subject to verification.
I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at-will" and without fixed term, and may be terminated at any time, with or without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing by an authorized Company official.
I authorize all references and former employers listed on my employment application to give the company any and all information concerning my previous employment and any pertinent information they might have, personal or otherwise, and release all parties from any claims, causes of action, or liability from damages that may or could result from furnishing such information to the company.
I understand that employment is contingent upon my complying with the employment verification requirements of the Immigration Reform and Control Act.
I certify that I have read, or have had read to me, items 1, 2, 3, 4 and 5 above. I understand the contents and hereby acknowledge receipt of this information.

I agree to the terms and conditions and all disclamers.
I do not agree.