WM Uniform Employment Application

WM Uniform is an Equal Opportunity Employer

Name:

First

Middle

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

Home Telephone Number

Phone:

Alternate Phone Number

Email:

Have you ever been employed at WM Uniform?

Yes
No

If Yes, list department & dates of employment:

Type of employment desired:

Regular
Part-Time
Temporary

Position for which you are applying:

Date Available:

Pay Rate Desired:

Qualifications-List education and certifications relevant to the position for which you are applying

School/Program

Degree/Certification

Relevant Skills Obtained

School/Program

Degree/Certification

Relevant Skills Obtained

School/Program

Degree/Certification

Relevant Skills Obtained

School/Program

Degree/Certification

Relevant Skills Obtained

Provide any additional skills/information you would like us to consider

Are you legally eligible to be employed in the United States?

If you are under the age of 18, are you able to furnish a work permit?

Are you able to perform the duties of the job for which you are applying?

How did you hear about this position?

Referred by Employee
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Other

Name of Employee

First

Last

Please explain

Employment History - List prior 3 employers starting with current/most recent employer (Including US Armed Forces service)

Current/Most Recent Employer

Company Name:

Address:

Job Title:

Department:

Supervisor's Name:

Dates Employed-From:

To:

Shift:

First Shift
Second Shift
Third Shift

Responsibilities:

Reason for Leaving:

Second Employer

Company Name:

Address:

Job Title:

Department:

Supervisor's Name:

Dates Employed-From:

To:

Shift:

First Shift
Second Shift
Third Shift

Responsibilities:

Reason for Leaving:

Third Employer

Company Name:

Address:

Job Title:

Department:

Supervisor's Name:

Dates Employed-From:

To:

Shift:

First Shift
Second Shift
Third Shift

Responsibilities:

Reason for Leaving:

The facts set forth above in my application for employment are true and complete. I understand that if employed, false statements or omission of information on this application, a resume, or other applicant information provided may be considered sufficient reason for dismissal. I understand that consumer reports which may contain public record information may be requested from the reporting agency. These reports may include information as to my character, work habits, performance, and experiences, along with reasons for termination of past employment from previous employers. Further, I understand that West Michigan Uniform may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil, and other experiences. I understand that I have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigative consumer report.

I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information.

I understand that the submission of this application does not mean that job openings exist and does not obligate West Michigan Uniform in any way. I further understand that employment at this organization is on an "at will" basis, and includes no guarantee, contract, or promise of employment for any specific length of time.

Signature

Date: