620.947.2664 INFO@CSIBOTTLES.COM

Employment Application

    Applicant Information

    Last Name (required)

    First Name (required)

    Middle Initial


    Street Address

    Apartment/Unit #


    City

    State

    Zip


    Phone Number

    Email Address (required)


    Date Available

    Shift

    Desired Salary


    Position applied for (Check all that apply)


    Are you a citizen of the United States?

    If NO, are you authorized to work in the U.S.?


    Have you ever applied to this company?

    If so, when?


    Do you have any relatives that work here?

    If so, who?


    What form of transportation do you have?


    Education

    High School

    Address

    Did you graduate?

    Degree



    College

    Address

    Did you graduate?

    Degree



    Other

    Address

    Did you graduate?

    Degree


    References

    Full Name

    Relationship


    Company

    Phone Number

    Address


    Full Name

    Relationship


    Company

    Phone Number

    Address


    Full Name

    Relationship


    Company

    Phone Number

    Address


    Previous Employment

    Please list your most recent employer first.

    Company

    Phone


    Address

    Supervisor


    Job Title

    Starting Salary

    Ending Salary

    Responsibilities

    From

    To

    Reason for Leaving

    May we contact this employer for a reference?


    Company

    Phone


    Address

    Supervisor


    Job Title

    Starting Salary

    Ending Salary

    Responsibilities

    From

    To

    Reason for Leaving

    May we contact this employer for a reference?


    Company

    Phone


    Address

    Supervisor


    Job Title

    Starting Salary

    Ending Salary

    Responsibilities

    From

    To

    Reason for Leaving

    May we contact this employer for a reference?


    Company

    Phone


    Address

    Supervisor


    Job Title

    Starting Salary

    Ending Salary

    Responsibilities

    From

    To

    Reason for Leaving

    May we contact this employer for a reference?


    Criminal Record

    Have you ever been convicted of any of the offenses in the drop-down list below?

    Click for list of offenses

    1. Abandonment of a Child
    2. Abuse
    3. Abuse of a Child
    4. Aggravated Abandonment of a Child
    5. Aggravated Arson
    6. Aggravated Battery
    7. Aggravated Burglary
    8. Aggravated Incest
    9. Aggravated Robbery
    10. Aggravated Sodomy
    11. Aiding Escape
    12. Altering a Legislative Document
    13. Arson
    14. Assault
    15. Assisting Suicide
    16. Battery
    17. Bigamy
    18. Blackmail
    19. Bribery
    20. Burglary
    21. Contributing to a Child’s Misconduct or Deprivation
    22. Criminal Damage to Property
    23. Criminal Nonsupport
    24. Criminal Restraint
    25. Criminal Threat
    26. Electronic Solicitation
    27. Endangering of a Child
    28. Exposing Another to a Life Threatening Communicable Disease
    29. Forgery
    30. Furnishing Alcoholic Liquor/Beverage or Cereal Malt Beverage to a Minor
    31. Harassment
    32. Hazing
    33. Illegal Use of Weapons of Mass Destruction or Furtherance of Terrorism
    34. Incest
    35. Indecent Liberties With a Child/Ward
    36. Indecent Solicitation of a Child
    37. Injury to a Pregnant Woman
    38. Interference with Parental Custody
    39. Interference with the Conduct of Public Business in a Public Building
    40. Interference with the Custody of a Committed Person
    41. Intimidation of a Witness or Victim
    42. Involuntary Manslaughter
    43. Kidnapping
    44. Lewd and Lascivious Behavior
    45. Making False Writing
    46. Mistreatment of a Confined Person
    47. Mistreatment of a Dependent Adult
    48. Murder
    49. Obstructing Legal Process or Official Duty
    50. Official Misconduct
    51. Patronizing a Prostitute
    52. Perjury
    53. Permitting Dangerous Animal to be at Large
    54. Poisoning
    55. Possession, Possession with the Intent to Sell
    56. Promoting Obscenity
    57. Promoting Prostitution
    58. Prostitution
    59. Rape
    60. Robbery
    61. Sale, Manufacture or Production of any Drug Listed in the Uniform Controlled Substances Act, KSA 65-4101 et. Seq.
    62. Sedition
    63. Sexual Battery
    64. Sexual Exploitation of a Child
    65. Sodomy
    66. Stalking
    67. Terrorism
    68. Theft
    69. Threat, Criminal or Terroristic
    70. Trafficking
    71. Treason
    72. Unlawful Administration of a Substance
    73. Unlawful Disclosure of Tax Information
    74. Unlawful Interference
    75. Unlawful Sexual Relations
    76. Vehicular Homicide
    77. Voluntary Manslaughter
    78. Any other crimes including attempts, conspiracies, and solicitation to commit any of the crimes listed

    If YES, give details, including offense, date and location.

    Offense #

    Date Convicted

    Details (including location where conviction occurred)


    Offense #

    Date Convicted

    Details (including location where conviction occurred)


    Offense #

    Date Convicted

    Details (including location where conviction occurred)

    Notice: Prior convictions will not necessarily bar you from employment with this company.


    Military Service

    Branch

    From

    To


    Rank at Discharge

    Type of Discharge

    If other than Honorable, explain:


    Disclaimer and Signature

    Please read carefully!

    In exchange for the consideration of my job application by Container Services, Inc. (hereinafter referred to as “the Company”), I agree that:

    Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Container Services, Inc., or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /Owner of the Company. Both the undersigned and Container Services, Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

    I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contact.

    I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.

    I understand that, in connection with the routine processing of my employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

    I further understand that my employment with the Company shall be provisional for a period of ninety (90) days, and further that at any time during the provisional period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

    Signature: Sign by clicking and dragging your cursor in the box below.

    Alternatively, you may type your full name in here as your signature:

    Date


    This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

    Thank you for completing this application form and for your interest in our business.