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JOIN OUR TEAM IN NORTHERN UTAH

Employment

Instructions: Complete all the necessary information. You may be asked to provide additional information on another form. This application will be kept on file. Be sure to read and agree to the statement at the bottom of this page.

SECTION I - Personal Information

* Denotes required fields

Personal Information

Name(Required)
Address(Required)
How did you learn about us?

Type of Employment(Required)
Have you ever been employed by our company?
If you are under 18, can you provide proof of your eligibility to work?
Are you currently employed?
Are you prevented from lawfully becoming employed in this country because of Visa? (Proof of citizenship will be required upon employment)
MM slash DD slash YYYY
What are you able to work?
Are you currently on 'Layoff Status' and subject to recall?
Can you travel if the job requires it?
Have you ever been bonded?
Have you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant from employment)
Are you capable of performing reasonable, with or without reasonable accommodation? The activities involved in the job or occupation for which you have applied?

SECTION II - Educational Information

Education

Elementary

High School

Undergraduate College

Graduate Professional

Other

Languages

Speak

Read

Write

Additional

(Do not answer this question unless you have been informed about the requirements for the job in which you are applying.)

SECTION III - Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations that indicate race, color, religion, gender, national origin, disabilities, or other protected status. If you need additional space to provide supplemental information, please write it on last page of this application. If this application is completed on-line, simply type the information on the last page of this application.

Past Employers - Employer #1

Complete Address

Dates Employed

MM slash DD slash YYYY
MM slash DD slash YYYY

Starting and Finishing Hourly Rate/Salary

Past Employers - Employer #2

Complete Address

Dates Employed

MM slash DD slash YYYY
MM slash DD slash YYYY

Starting and Finishing Hourly Rate/Salary

Past Employers - Employer #3

Complete Address

Dates Employed

MM slash DD slash YYYY
MM slash DD slash YYYY

Starting and Finishing Hourly Rate/Salary

Past Employers - Employer #4

Complete Address

Dates Employed

MM slash DD slash YYYY
MM slash DD slash YYYY

Starting and Finishing Hourly Rate/Salary

SECTION IV - References And Additional Information

References #1

Complete Address

References #2

Complete Address

References #3

Complete Address

References #4

Complete Address
Add any additional information here that you believe will be helpful. You may be asked to provide hard copies of additional information, such as your resume or Employee Data Cards.

SECTION V - Submit

The applicant must read and agree with the following text. After reading, check the box at the bottom and press the submit button.
Employment Application(Required)
I certify that I have read and understand all of this employment application. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or nor, and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks that are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical examination and drug test. I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason. I understand that misrepresentation or omission of information or facts may result in my rejection or dismissal. If hired, I agree to abide by all the rules and policies of the employer. This certifies that this application was completed by me, and that all entries and information on it are true and complete to the best of my knowledge.
CONTACT INFORMATION

520 S State, Clearfield, UT 84015

[email protected]

Hours Of Operation:

Mon-Fri: 8:00 am - 5:00 pm

Saturday: 8:00 am - 4:00 pm

Sunday: Closed

Find Us On:

PHONE NUMBERS

Davis/Morgan: 801-773-4836

Weber County: 801-393-1265

Brigham City: 435-553-4556

Salt Lake: 801-292-1636

VISIT US

© Dick Kearsley Service Center 2023

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