General Information

► indicates a REQUIRED field

Position:

.General Job Application

► Interested in Location:

Resume Upload:

Position Description:

Please apply here only when there is no specific job listed that you are applying to.

Applicant Information

Date Available:

► Full Name:

► Telephone #:

► Email:

Referred by:

Address (Line 1):

Address (Line 2):

► City:

► State:

► Postal Code:

► Salary requirements per hour or annual:

► Sales & Yard positions may be required to lift up to 100lbs. Are you capable of this essential job function? YesNo

► Are you 18 years or older? YesNo

If not 18, Date of Birth:

► Are you currently Employed?: YesNo

► If employed, may we contact your employer?: YesNoN/A

► Have you ever been disciplined or fired?: YesNo

If disciplined or fired, why?

► Have you ever been convicted of a felony within the last 7 years? YesNo

If convicted of a felony, why?

► Are you able to work Overtime? YesNo

► Are you able to work Saturdays? YesNo

Employment History

List most recent employment first. Include summer or temporary jobs.

Employer 1 (Most Recent)

Employer Name:

Employer Address:

Pay Rate:

Supervisor:

Contact #:

Start Date:

End Date:

Reason for Leaving:

Brief Description of Duties:

Employer 2

Employer Name:

Employer Address:

Pay Rate:

Supervisor:

Contact #:

Start Date:

End Date:

Reason for Leaving:

Brief Description of Duties:

Employer 3

Employer Name:

Employer Address:

Pay Rate:

Supervisor:

Contact #:

Start Date:

End Date:

Reason for Leaving:

Brief Description of Duties:

Education

Name of Institution

Years Completed

Field of Study

Graduate / Degree

High School

College / University

Business / Technical

Additional

Driving Record

Only necessary if position requires driving.

State

License No.

Type

Expiration

License 1

License 2

License 3

Class of Equipment

Type of Equipment (van, tank, flat, etc)

License No.

Date From

Date To

Approx. # of miles (total)

Straight Truck

Moffitt Truck

Forklift

Other

List any Violations, Forfeitures, and/or Accidents in the last 3 years:

References

Please list two references personal (not relatives) or professional.

Name

Telephone

Relationship

Years Known

Additional Comments

Comments:

I hereby authorize A.D. Moyer Lumber Co., Inc. to contact prior employers listed above to obtain any and all information related to my past work performance.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.

I understand and agree that my typed in name on the signature line of this employment application is the equivalent of an in person signature by me, and for all purposes, now and in the future, the company and its related entities, shall be entitled to consider it as such.

► Signature / Your Full Name

A.D. Moyer Lumber Co., Inc. is an equal opportunity employer and does not discriminate against otherwise qualiﬁed applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status. Equal Opportunity Employer.

Upon successful completion of all required fields above, you will be redirected to the main "Careers/Employment" page in your browser window with a confirmation message and you will also receive an acknowledgment via email.

Career Application

Notice To All Applicants

General Information

Applicant Information

Employment History

Employer 1 (Most Recent)

Employer 2

Employer 3

Education

Driving Record

References

Additional Comments

Career Application

Notice To All Applicants

** General Information **

** Applicant Information **

** Employment History **

Employer 1 (Most Recent)

Employer 2

Employer 3

** Education **

** Driving Record **

** References **

** Additional Comments **

General Information

Applicant Information

Employment History

Education

Driving Record

References

Additional Comments