RoadMasterTrucking is Always Looking for Great Additions to Our Team! Office / Administrative APPLICATION FOR EMPLOYMENT It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, or other protected classification. Position(s) applied for Name Address City State Zip Code Telephone Number Are You Over 18 Years Old? YesNo Are you authorized to work in the U.S. on an unrestricted basis? YesNo How did you learn of this opening? Have you worked here before? YesNo Have you been told the essential functions of the job or have you been shown a copy of the job description listing the essential functions of the job? YesNo Can you perform these essential functions with or without reasonable accommodation? YesNo Are there any hours, shifts or days you cannot or will not work? YesNo Are you willing to work overtime as required? YesNo Have you ever been convicted of a felony? YesNo (Conviction will not necessarily disqualify an applicant for employment.) If yes, describe conditions: High School Name And Location Diploma Degree YesNo College/University Name And Location Year Graduated Major Diploma Degree YesNo Other Training/Education In addition to your work history (reverse side), what other experiences, skills or qualifications would especially fit you for work with our company? Work History May we contact your present employer? YesNo Previous Employeer Address Telephone Date Started Starting Salary Starting Position Date Left Salary On Leaving Position On Leaving Name And Title Of Supervisor Description Of Duties Reasons For Leaving Previous Employeer Address Telephone Date Started Starting Salary Starting Position Date Left Salary On Leaving Position On Leaving Name And Title Of Supervisor Description Of Duties Reasons For Leaving Previous Employeer Address Telephone Date Started Starting Salary Starting Position Date Left Salary On Leaving Position On Leaving Name And Title Of Supervisor Description Of Duties Reasons For Leaving APPLICANT'S CERTIFICATION AND AGREEMENT I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Company to make an investigation of any of the facts set forth in this application and release from any liability both the Company and those who supply reference information. I also understand that the job description shown to me is an estimate of the nature and amount of work to be performed and that the job requirements are subject to change. I understand that employment at this Company is "at-will," which means that either I or the Company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager or executive of the Company, other than the president has any authority to alter the foregoing. Δ