Employment Application Step 1 of 5 20% Personal Information - Complete all applicable informationName (Last, First, MI)*Position(s) Applied For:*Are you willing to work full-time?* Yes No Are you willing to work weekends?* Yes No Are you willing to work evenings?* Yes No Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Primary Phone:*Secondary Phone:Have you previously been employed by our company?* Yes No Last Date Worked / Where?Are you legally authorized to work in the United States?* Yes No - Require Sponsorship When could you start employment?* Date Format: MM slash DD slash YYYY Have you ever applied for employment with our company?* Yes No When / Where?Are you related to anyone currently or previously employed by our company?* Yes No Name & Relationship? Employment History - Include your last seven (10) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information may disqualify you from further consideration.Present or Last Position:*Name of Company:*From Mo/Yr:To Mo/Yr:*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Reason for Leaving:*Summary of Duties:*Starting Annual Salary:*Final Annual Salary:*Bonus:Commission:Name of Supervisor:*Supervisor Title & Department:*Supervisor Phone Number:*May we contact?* Yes No Present or Last Position:Name of Company:From Mo/Yr:To Mo/Yr:Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Reason for Leaving:Summary of Duties:Starting Annual Salary:Final Annual Salary:Bonus:Commission:Name of Supervisor:Supervisor Title & Department:Supervisor Phone Number:May we contact? Yes No Present or Last Position:Name of Company:From Mo/Yr:To Mo/Yr:Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Reason for Leaving:Summary of Duties:Starting Annual Salary:Final Annual Salary:Bonus:Commission:Name of Supervisor:Supervisor Title & Department:Supervisor Phone Number:May we contact? Yes No Education InformationHigh School:City:StateDiploma / GED Year:General Ed. or Advanced Classes:College:City:State:Degree:Major:GPA:College:City:State:Degree:Major:GPA:Graduate School:City:State:Degree:Major:GPA:Other:City:State:Degree:Major:GPA: Driving Information (OPTIONAL) - Complete only if driving is an essential function of the job which you are applying.Do you have a current valid driver's license? Yes No Has your license ever been suspended or revoked? Yes No Please list all moving traffic violations in the last five (5) years:Offense:Date: (mm/yy)Location:Comments:Offense:Date: (mm/yy)Location:Comments: PLEASE READ THE FOLLOWING STATEMENTS CAREFULLYBrown Sand, Inc/Magnum Transportation, Inc. is an equal opportunity employer. Brown Sand, Inc/Magnum Transportation, Inc. does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex, gender, sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service. I understand that neither the completion of this application nor any other part of my consideration for employment any obligation for Brown Sand, Inc./Magnum Transportation, Inc., to hire me. If I am hired, I understand that either Brown Sand, Inc/Magnum Transportation, Inc., or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Brown Sand, Inc./Magnum Transportation, Inc. has the authority to make any assurance to the contrary. I attest with my signature below that I have given to Brown Sand, Inc/Magnum Transportation, Inc. true and complete information on this application. No requested information has been concealed. I also understand that Brown Sand, Inc./Magnum Transportation, Inc. may request to contact references provided for employment reference checks, and under consistent hiring practices, as a condition of employment upon any employment offer. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.Date Date Format: MM slash DD slash YYYY Signature
