PRICE REFRIGERATION 843-651-3793 fax: 843-651-7925
3979 Hwy. 17 Bypass, Murrells Inlet, SC 29576
EMPLOYMENT APPLICATION
(PLEASE PRINT)
DATE ______________________
Legal Name:______________________________________________________________________________________________
Mobile Telephone: (___)___________________________ Home Telephone: (___)___________________________
Address: _____________________________________________________________________________________
Date of birth:_______________________________________SS#__________________________________________
Position: __________________________________________________________________________________
Certifications: (example EPA)______________________________________________________
Drivers License #_____________________________________State___________________
Education Level:
______________________________________________________________________
Do you have any other experience, training, qualifications or skills which you feel make you especially suited for employment? _________________________________________________________________________________________________
Present or past employment (if resume' not attached) Employer:___________________________________________________________________________________
Address:_______________________________________________________________________________________Type Business:_____________________________________________________________________________________
Telephone: (___)______________________
Your Supervisor’s Name:_________________________________________
Your Position and Duties:__________________________________________________
Dates of Employment: From:______________________________To:___________________________________
May we contact this employer?....................................................................................................................... Yes No
Reason Leaving:____________________________________________________________________________________
Please identify and explain all periods of unemployment for past three years.
dates: from:____________________to________________reason_____________________________
Please identify past workers compensation layoff:
Dates: from:_____________________to________________reason_____________________________
Explain details of layoff_______________________________________________________________
Acknowledgment
Please read carefully, initial each paragraph, and sign below.
______ I hereby certify that the information contained in this application is true and correct to the best of my knowledge.
I further certify that I, the undersigned applicant, have personally completed this application. I understand that any misrepresentation, falsification or omission of information on this application or any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless of the time elapsed before discovery.
______ I hereby authorize the Company to perform back ground check, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the Company all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons or entities from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures.
______The Company adheres to a policy of AT-WILL employment which means that each employee and the Company each retain the right to terminate the employment relationship and that the Company retains the right to modify an employee’s position or compensation at any time, with or without cause or notice. No one other than the President has the authority to make any binding promise or enter into any agreement inconsistent with Company’s at-will policy and any such agreement must be in writing and signed by both the employee and the President of the Company to be effective.______ As a condition of employment, all individuals offered employment are required to submit to a pre-employment drug test, physical, and skill test.
Date:_______________________________ Applicant’s Signature:______________________________________________