Starting Wages
1st – $14.30 2nd – $14.60 3rd – $15.80

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

12Weekend ShiftAny

Desired Salary

Position applied for (Check all that apply)

PackerMaterial HandlerMaintenanceOther

Are you a citizen of the United States?

YESNO

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

YESNO

Have you ever applied to this company?

YESNO

If so, when?

HOW DID YOU HEAR ABOUT US?

Do you have any relatives that work here?

YESNO

If so, who?

What form of transportation do you have?

Personal AutoBikeWalkFriend/Relative

Education

High School

Address

Did you graduate?

YESNO

Degree

College

Address

Did you graduate?

YESNO

Degree

Other

Address

Did you graduate?

YESNO

Degree

References

Please list 3 work references.

Full Name

Relationship

Company

Phone Number

Address

Full Name

Relationship

Company

Phone Number

Address

Full Name

Relationship

Company

Phone Number

Address

Current Employment

Please list your current employer here. If you are not currently employed, then go to the next section, Previous Employment.

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

May we contact this employer for a reference? YESNO

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

Criminal Record

Have you ever been convicted of any of the offenses in the list below? YESNO

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

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.