R. J. Zavoral & Sons, Inc. is an Equal Opportunity Employer
Position Applied For
High School Name and Location
High School Graduate
College Name and Location
College Areas of Study
Post High School/Technical Training Name and Location
Post High School/Technical Training Areas of Study
Post High School/Technical Training Graduate
Post High School/Technical Training Degree
On what date would you be available for work?
Are you currently on a "lay-off" status and subject to recall?
Full TimePart TimeShift WorkTemporary
Days available for work
Are you at least 18 years of age?
Truck Driving Experience Type
Truck Driving Experience Years
Equipment Operating Experience Type
Equipment Operating Experience Years
Other, ie Computers, Software Experience Type
Other Experience Years
Do you have a valid driver's license?
Class (please select one)
Do you have a Medical Examiner's Certificate?
If Yes, Date of Expiration
Driver's License Number
State of Issue
Are you CPR Certified?
Date Certificate Expires
Are you First Aid Certified?
Are you MSAH Certified?
Hours of OSHA Training
Date of OSHA Training
Do you have any physical conditions which may limit your ability to perform the job applied for?
If yes, please explain
What can be done to accommodate your limitation?
Would you be willing to take a physical examination?
PRE-EMPLOYMENT DRUG TESTS WILL BE CONDUCTED
Include only individuals familiar with your work experience. Do not include relatives.
Are you a Special Disabled Veteran?
Are you a Vietnam Era Veteran?
Are you currently employed?
May we contact your present employer?
Reason For Leaving
I certify that all information given is accurate and true. I understand that if hired, any false information on this form could be cause for termination. I authorize R.J. Zavoral & Sons, Inc. to obtain and give references as well as to verify my information such as credit history, DMV records, employment, and education as needed for arriving at an employment decision. I understand that R.J. Zavoral & Sons, Inc. utilizes "employment-at-will", i.e., the employee or the Employer may terminate the employment relationship at any time for any reason other than an unlawful or discriminatory reason.
Applicant's Signature (Please type full name here.)