D&G Resources, LLC.

 

Employment Application

Personal Information:

First Name                                    M. I.              Last Name                             Social Security No.

Current Address                                          City                                   State               Zip Code

Permanent Address                                      City                                  State               Zip Code

Home Phone                 Cell Phone                       Email address

   

Employment Position Desired                          Date you can start         Salary Desired

Are you currently employed: Yes   No  If so, may we contact your current employer Yes   No

Have you ever applied to this company before Yes   No   When?

 

Education History

Name & Location of Grammar School:               Year Attended                     Did you Graduate    Subjects Studied

YesNo     

Name & Location of High School:                     Year Attended                     Did you Graduate    Subjects Studied

YesNo     

Name & Location of College School:                 Year Attended                    Did you Graduate    Subjects Studied

YesNo     

Trade, Business, Etc. School:                              Year Attended                   Did you Graduate    Subjects Studied

YesNo     

 

General Information

Please list any special skills, licenses, or abilities that you have including hobbies & volunteer work.

 

Previous Employment: Please list your last four employers with most recent first.

Start (mm/yy)  End (mm/yy)    Name & Address of Employer                  Salary           Position                Reason for Leaving

   

Start (mm/yy)   End (mm/yy)   Name & Address of Employer                  Salary           Position                Reason for Leaving

   

Start (mm/yy)   End (mm/yy)   Name & Address of Employer                  Salary           Position                Reason for Leaving

   

Start (mm/yy)   End (mm/yy)   Name & Address of Employer                  Salary           Position                Reason for Leaving

   

 

References:

Name                                                   Company                                           Relationship                                      Phone Number

Name                                                   Company                                           Relationship                                      Phone Number

Name                                                   Company                                           Relationship                                      Phone Number

Name                                                   Company                                           Relationship                                      Phone Number

 

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 above 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 and 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."

Date: (mm/dd/yyyy) Name or signature if printed:   

I understand and agree with the authorization: Place a check mark in the box

 

If you are satisfied with the form please click to send the application to D&G Resources, LLC.

If you like to clear the contents of the form please click on .