**Name/Address, Position/Type of work performed, Start Date, End Date, End Wage, Reason for Leaving
**High School, College, Other. Please list Name, Location, years completed, and if graduated. Also, list course of study.
**Please list Name, Address, Phone, and Relationship
I understand and agree that if I am employed, my employment will be "at-will", which means that the Company may terminate the employment relationship at any time, with or without cause and with or without notice. I understand that the use of illegal durgs is prohibited during employment. I may be requried to successfully pass a drug and alcohol screening examination prior to being hired, and I consent to taking a drug and alchohol test at any time during my employment, should I be hired. I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at any later date.
I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
It is the policy of Cottle's Asphalt to provide equal employment opportunity to all qualified applicants for employment without regard to race, color, religion, national origin, sex, age, veteran status or disability. Various agencies of the government require employers to invite applicants to identify themselves. COMPLETION OF THIS FORM IS VOLUNTARY AND IN NO WAY AFFECTS THE DECISION REGARDING YOUR APPLICATION FOR EMPLOYMENT. THIS FORM IS CONFIDENTIAL AND WILL BE MAINTAINED SEPARATELY FROM YOUR APPLICATION FORM.
Definitions of Ethnicity Categories