Join the Team Step 1 of 4 25% Personal Information:Name* Phone Number*Present Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Enter Email Confirm Email Referred By:Date You Can StartMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Desired Employment PositionDesired SalaryCurrently Employed?YesNoMay We Inquire Present Employer?YesNoHave You Ever Worked Here Before?YesNoWhen?Have You Been Convicted Of A Crime In The Last Five (5) Years?YesNoExplain:Do You Have Reliable Transportation?YesNoAre You Available To Work Overtime?YesNoAre You Authorized To Work In The US?*YesNo Education HistoryHigh School?YesNoName And Location Of High School:Did You Graduate?YesNoYears Attended?College?YesNoName And Location Of SchoolDid You Graduate?YesNoYears Attended?Trade, Business, Or Correspondence School?YesNoName And Location Of School:Did You Graduate?YesNoYears Attended? Former Employers:Start With Most Current Employer Name & Phone Number Of Employer:*Date of Employment:*Salary:Position:Reason For Leaving:Do You Have Another Employer To Add?*YesNoName & Phone Number Of Employer:Date of Employment:Salary:Position:Reason For Leaving:Another Employer?YesNoName & Phone Number Of Employer:Date of Employment:Salary:Position:Reason For Leaving: ReferencesGive Below The Names Of Three (3) People Not Related To You, Whom You Have Known For At Least One (1) Year*NamePhone NumberYears Known Please List Any Relatives Currently Employed At Bloomer TrailersName Comments: Please list any special skills or certifications.Upload a resume (optional)Authorization: "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing signed by an authorized company representative.This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."10/26/202034.232.51.240Do You Authorize:*YesNo
