Home > Employment Application

Employment Application

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    Personal Information

    Hourly orAnnually
    Level and Type of Education School Name City and State Last Year Completed Did You Graduate?
    High School 9101112 YesNo
    College or University < 1 Year1234 Degree
    Additional Schooling Number of Years:
    		Certificate or License

    Special Skills

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    Employment Record

    User must at least fill out one previous or current job to proceed to step 3

    Please list your most recent jobs first. Include military service as part of your employment record. If you have a resume, please attach it to this form.

    Employer Address
    Telephone Number Supervisor’s Name
    Job Title Dates of Employment (month and year)
    From To
    Reason for Leaving Essential Job Duties
    Employer Address
    Telephone Number Supervisor’s Name
    Job Title Dates of Employment (month and year)
    From To
    Reason for Leaving Essential Job Duties
    Employer Address
    Telephone Number Supervisor’s Name
    Job Title Dates of Employment (month and year)
    From To
    Reason for Leaving Essential Job Duties
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    General Information

    User must select yes/no on each question to submit application.

    May we contact your present employer?
    Do you have the legal right to work in the United States? (If hired, you will be required to provide identification to prove eligibility for employment)
    Have you been employed or attended school using any other name? If yes, please indicate names previously used:
    Are you able to perform the primary duties of the job as outlined in the newspaper advertisement, announcement, posting, job line, job description, with or without reasonable accommodation? If no, please explain:
    Were you referred by a current Patrick Lumber Manufacturing employee? If yes, please provide their name:

    Additional Information

    Please use the space provided to list any additional employers, periods of time not worked, or any other information that you believe we should know in considering your application for employment.

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    Please read carefully, and sign below

    I certify that I have answered the above questions truthfully and have not withheld any information relative to my application. I understand that any falsification, misrepresentation, or omission, as well as any misleading statements or omissions of the application information, attachments, and supporting documents generally will result in denial of employment or immediate termination, if discovered after hire.

    I authorize Patrick Lumber Manufacturing, LLC to thoroughly investigate my references, work record, education, and other matters related to my suitability for employment, and further authorize the references I have listed to disclose to the organization any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I release Patrick Lumber Manufacturing, LLC, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.

    I authorize Patrick Lumber Manufacturing, LLC to investigate whether I have a criminal record of convictions, and, if so, the nature of such convictions and all the surrounding circumstances of the conviction. Patrick Lumber Manufacturing, LLC has advised me that any criminal background check will focus on convictions, and that a criminal record will not necessarily disqualify me from employment.

    If hired, I recognize the rules and policies of Patrick Lumber Manufacturing, LLC. I understand that my employment and compensation can be terminated at any time, with or without cause, and with or without notice, at the option of Patrick Lumber Manufacturing, LLC or myself. I understand that management of the organization are the only people who will ever have the authority to create any other terms of employment and/or to enter into any employment contract and that all such contracts must be in writing and signed by both parties. However, I also understand that unless otherwise stated in an employment contract, the organization may change, withdraw, and interpret other policies (including wages, hours and working conditions) as it deems appropriate.

    If hired, I understand and acknowledge that I may be required to submit to a physical examination, including drug test. Additionally, I would then need to authorize the release of the results of such an examination to Patrick Lumber Manufacturing, LLC for their use in evaluating my suitability for employment. Further, I would also need to release the examining facility and Patrick Lumber Manufacturing, LLC from any and all liability, and from any damage that may result from the release of such information.

    Applicant Signature

    How to Use: Sign by dragging the mouse in the field while holding down the mouse button.


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    Employment Application