Application

Summit Environmental Services, LLC Employment Application

The following information is requested in order to help us make a thorough evaluation of your request for employment. All portions of this application must be completed. If a question does not pertain to you, please mark it "NA".

Current Date*

Date Available for Work?*

Position Desired?*

Salary Desired?*

Personal Data

Name*

First Last

SSN#*

Have you ever worked under another name?*

Yes
No

If yes, given name:*

Address

Street Address Address Line 2 City State ZIP Code

Phone*

Email

Check type of employment*

Over the age of 18?*

Yes
No

A previous applicant?*

Yes
No

A previous employee?*

Yes
No

Legally able to work in the United States?*

Yes
No

Other than traffice violations, have you ever been convicted of a crime? Yes - No (Conviction is not necessarily a bar to employment)*

Yes
No

If yes, describe in detail:*

Work Experience

Begin with your current job and work backward in order, listing your current and previous two employers including all full-time and part-time employment. All time must be accounted for including military service, self-employment and periods of unemployment.

Present/Last Employer:

Phone

Type of business:

Start Date

Leave Date

Salary:

Job Title

Supervisor & Title:

May we contact?

Yes
No

Reason for leaving?

Description of job and duties:

Previous Employer:

Phone

Type of business:

Start Date

Leave Date

Salary:

Job Title

Supervisor & Title:

May we contact?

Yes
No

Reason for leaving?

Description of job and duties:

Previous Employer:

Phone

Type of business:

Start Date

Leave Date

Salary:

Job Title

Supervisor & Title:

May we contact?

Yes
No

Reason for leaving?

Description of job and duties:

Education and Training

Name of High School*

School Address

Street Address Address Line 2 City State ZIP Code

Field of Study?

Did you graduate?*

Yes
No

Degree Earned:

Name of College/Tech School

School Address

Street Address Address Line 2 City State ZIP Code

Field of Study?

Did you graduate?

Yes
No

Degree Earned:

Other Training

School Address

Street Address Address Line 2 City State ZIP Code

Field of Study?

Did you graduate?

Yes
No

Degree/Certification Earned:

Additional Qualifications

What knowledge, skills, and/or individual capabilities do you have which especially prepare you for the position you have applied for?

Military

Branch of Service:

Rank at Discharge:

Dates of Service:

List duties in the sevice, including schools and training:

References

Please provide three references other than family members:

Name

First Last

Phone

Occupation

Name

First Last

Phone

Occupation

Name

First Last

Phone

Occupation

I certify that the information contained in this application is correct to the best of my knowledge, and understand that falsifications of this application in any detail is grounds for disqualification from further consideration or for dismissal from employemnt regardless of when the falsification is discovered. By signing this application, I am authorizing the Company to contact my previous employers. I am also authorizing my previous employers to release information about me that they have knowledge of or that may be contained in their records regarding my record of service, conduct, attendance and character. I do hereby release my previous employers from any and all liability which may result from providing such information to the Company.*

I understand and accept conditions

Electric Signature - Please type your First and Last Name.*

Electric Signature - Date*

Resume

Max. file size: 256 MB.

Cover Letter

Max. file size: 256 MB.

Misc.

Max. file size: 256 MB.

All qualified applicants receive consideration for employment without regard to race, color, religion, sex, age, national origin or veteran status.

Enter your email Address

Summit Environmental Services, LLC Employment Application

Personal Data

Work Experience

Education and Training

Additional Qualifications

Military

References