Job Application

APPLICANT INFORMATION

Full Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Birth Date(Required)

Social Security Number(Required)

Do you have a Drivers License?(Required)

Yes

Drivers License #(Required)

Position Applying for:

Are you a citizen of the United States?(Required)

Yes

If no, are you authorized to work in the U.S.?(Required)

Yes

Have you ever worked for this company?(Required)

Yes

If so, when?(Required)

Have you ever been convicted of a felony?(Required)

Yes

If yes, explain(Required)

EDUCATION

Name of High School(Required)

Did you graduate?(Required)

Yes

High School Graduation Year(Required)

Diploma:(Required)

Did you attend college?(Required)

Yes

Name of College(Required)

College Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

College Start Date(Required)

College End Date(Required)

Did you graduate?(Required)

Yes

Degree(Required)

Have you attended any other educational institutions?(Required)

Yes

Name of Educational Institution(Required)

Educational Institution Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Institution Start Date(Required)

Institution End Date(Required)

Did you graduate/complete program?(Required)

Yes

Degree/Certification(Required)

REFERENCES

Please list three professional references

Reference #1 Full Name(Required)

Your relationship to Reference #1(Required)

Reference #1 Company(Required)

Reference #1 Phone Number(Required)

Reference #2 Full Name(Required)

Your relationship to Reference #2(Required)

Reference #2 Company(Required)

Reference #2 Phone Number(Required)

Reference #3 Full Name(Required)

Your relationship to Reference #3(Required)

Reference #3 Company(Required)

Reference #3 Phone Number(Required)

PREVIOUS EMPLOYMENT

Are you currently employed?(Required)

Yes

Current Employer Company(Required)

Current Employer Phone Number(Required)

Current Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current Employer Supervisor(Required)

Current Job Title(Required)

Starting Salary at Current Employment(Required)

Ending Salary at Current Employment(Required)

Responsibilities at Current Employment(Required)

Current Employment Start Date(Required)

Reason your seeking other employment(Required)

May we contact your current supervisor for a reference?(Required)

Yes

Have you ever been previously employed?(Required)

Yes

Previous Employer Company Name(Required)

Previous Employer Phone Number(Required)

Previous Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employer Supervisor(Required)

Previous Employer Job Title(Required)

Previous Employment Starting Salary(Required)

Previous Employment Ending Salary(Required)

Responsibilities at Previous Employment(Required)

Previous Employment Start Date(Required)

Previous Employment End Date(Required)

Reason for Leaving Previous Employment(Required)

May we contact your previous supervisor for a reference?(Required)

Yes

Do you have other previous employment?(Required)

Yes

Previous Employer #2 Company Name(Required)

Previous Employer #2 Phone Number(Required)

Previous Employer #2 Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employer #2 Supervisor(Required)

Previous Employer #2 Job Title(Required)

Previous Employment #2 Starting Salary(Required)

Previous Employment #2 Ending Salary(Required)

Responsibilities at Previous Employment #2(Required)

Previous Employment #2 Start Date(Required)

Previous Employment #2 End Date(Required)

Reason for Leaving Previous Employment #2(Required)

May we contact your previous employment #2 supervisor for a reference?(Required)

Yes

MILITARY SERVICE

Have you served in the military?(Required)

Yes

Branch of Military(Required)

Service Start Date(Required)

Service End Date(Required)

Rank at Discharge(Required)

Type of Discharge(Required)

If other than honorable, explain(Required)

DISCLAIMER AND SIGNATURE

I. The facts as stated on this application are true and correct. I understand that, if employed, false statements on this application may cause immediate dismissal.

II. I authorize this employer to obtain such background and personal information on me as it deems necessary to verify the information I have supplied is true and accurate and to determine my fitness for this job. I hold harmless anyone who is asked to provide such information to this employer. A copy of this authorization is as valid as the original.

III. I understand that I may be required to work overtime as a condition of being employed.

IV. In consideration of my employment, I agree to conform to the rules and regulations for employees. I understand that I am an employee at will, and that this application is not a contract of employment with this employer and that my employment and compensation can be terminated, with or without cause, at any time, at the option of either this employer or me. I understand that no representative of this employer has any authority to enter into any verbal agreement for employment for any specified period of time or to make any agreement contrary to the forgoing and that no document, policy or practice of this employer may change the foregoing unless it is expressly titled (Employment Agreement and signed by both myself and an officer of this employer).

V. I understand that I may be required to submit a test for illegal drug use prior to any offer for employment, a medical examination after a conditional offer of employment, and test for fitness and/or substance abuse after employment, if not prohibited by law.

VI. Upon separation of employment, I authorize this employer to withhold from my final paycheck and monies owed to them by me.

Signature(Required)

Signature Date(Required)

Employee Login Portal

George B. Stone Co. Employment Application

APPLICANT INFORMATION

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

MILITARY SERVICE

DISCLAIMER AND SIGNATURE

© George B. Stone Co.
All Rights Reserved.

Employee Login Portal

Job Application

George B. Stone Co. Employment Application

APPLICANT INFORMATION

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

MILITARY SERVICE

DISCLAIMER AND SIGNATURE

© George B. Stone Co. All Rights Reserved.

© George B. Stone Co.
All Rights Reserved.