Application

Application for Employment

 

Authorization to Release & Investigate Personnel Records

 

Thank you for your interest in applying for a job with Reliance Interiors, Inc. We are an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on any basis including race, age, sex, religion, disability, national origin, and marital or veteran status. Please understand that our acceptance of this application does not create an obligation for us to hire you, nor that you must work for us. Be advised that your signature on this application has certain legal consequences. Therefore, we advise you to read the "Applicants Acknowledgement" section at the end of this application very carefully before you answer the questions set forth.

 

GENERAL INFORMATION

 

Email Address:
Position:
Requested Hourly Rate:
Name:
Social Security Number:
Address:
City:
State:
Zip:
Date of Birth:
Home Phone:
Work or other phone:

 

If you are applying for a position that requires you to drive on company business, you will be required to provide valid driver's license information:

 

Drivers License Number:
State Where Issued:
In case of emergency, please notify:
Relationship:
If less than 5 years at current address:
How long at current address?
Previous Address:
City:
State:
Zip:
Are you legally entitled to work in the United States?
You must show proof.
Immigration Status:
Are you at least 18 years of age?
Have you ever been convicted of ANY crime?
If yes, please explain:
Have you ever been terminated from a job for which
you were entitled to collect unemployment?
If yes, please explain:
Have you ever sustained a work related injury,
or filed a Worker's Compensation Claim?
If yes, please explain:

 

EDUCATION

 

High School:
Did you graduate?
College:
Did you graduate?
Graduate:
Did you graduate?
If in school, please list your class schedule:
Monday
Tuesday
Wednesday
Thursday
Friday

 

WORK RECORD FOR THE LAST 5 YEARS

 

Company:
From:
To:
Position:
Address:
City:
State:
Acquired Skills:
Supervisor:
Supervisor Phone:
Salary:
Per Hour
Reason for leaving

Company:
From:
To:
Position:
Address:
City:
State:
Acquired Skills:
Supervisor:
Supervisor Phone:
Salary:
Per Hour
Reason for leaving

Company:
From:
To:
Position:
Address:
City:
State:
Acquired Skills:
Supervisor:
Supervisor Phone:
Salary:
Per Hour
Reason for leaving

Company:
From:
To:
Position:
Address:
City:
State:
Acquired Skills:
Supervisor:
Supervisor Phone:
Salary:
Per Hour
Reason for leaving

 

PERSONAL REFERENCES

 

Name:
Relationship:
Address:
City:
State:
Zip:
Telephone:

Name:
Relationship:
Address:
City:
State:
Zip:
Telephone:

Name:
Relationship:
Address:
City:
State:
Zip:
Telephone:

Name:
Relationship:
Address:
City:
State:
Zip:
Telephone:

 

APPLICANT'S ACKNOWLEDGMENT

 

It is very important that you read this section carefully, and that you fully understand it before you sign it. This section affects your legal rights. If you have any questions regarding those legal rights, please ask before you sign this application. If you do not ask, we will assume you fully understand.

 

  • I promise that all the information I have supplied in this application, and any other information oral or written, is true and accurate. I understand that any misstated, misleading, incomplete or false information is grounds for rejection of this application, refusal to hire, a withdrawal of an offer of employment, or immediate discharge without recourse, whenever and however discovered.
  • I hereby authorize Reliance Interiors, Inc., its agents or assigns, to contact my previous employers to request references. Further, I agree to hold Reliance Interiors, Inc. and any such previous employer harmless for disclosure and authorize them to release any and all information pertaining to me and my employment.
  • I understand that Reliance Interiors, Inc, maintains a drug free workplace. I am applying to work at a location that may require a drug and alcohol screening, undergo a post-job offer medical examination, or pencil and paper test, designed to determine my suitability for the job which I am being considered. Additionally, from time to time, I may be required to take subsequent tests during the course of my employment and consent to such post-job offer and post-hire testing. I understand that, subject to applicable law, Reliance Interiors, Inc. shall be the sole judge of the acceptability of any test results.

 

I acknowledge, and where applicable consent to the following:

 

  • My employment is at will;
  • I may be discharged for any reason, without notice;
  • I am subject to a 90 day employment period;
  • Successful completion of my evaluation period does not change our at will employment relationship;
  • Reliance Interiors, Inc. may conduct a criminal background, driver’s license, education, verifications and check my references;
  • Work schedules may vary and can be unpredictable, and as such, I may be required to work n different shift, weekends or overtime;
  • I will be required to comply with all policies;
  • Reliance Interiors, Inc. reserves the right to amend, change, all policies at will;
  • I will contact Reliance Interiors. Inc. if I feel that I have been unlawfully discriminated against by an employee, supervisor or manager in connection with my employment. Further, I agree to give Reliance Interiors, Inc. an opportunity to resolve the situation before I file a claim with a government agency of file a lawsuit:
  • I fully understand that if I sustain an on the job injury, I must notify my supervisor as well as the main office immediately. I have been informed that all job sites contain a posted panel of physicians and if I sustain an injury I will seek treatment at one of the posted physicians.

 

Applicant's Printed Name
Applicant's Signature
Date

During the last several years, Reliance Interiors has completed over $5 million of metal stud framing and drywall for JM Wilkerson. Their acute attention to schedule adherence and quality control makes our job as a General Contractor easier to manage.

 

- Darren Sayer, J.M. Wilkerson Construction Co.