Job Application

Personal Information

Name:

Date:

Phone #:

Phone #:

Address:

City:

State:

Zip:

    Have you applied for employment with us in the past 3 years?
    YesNo

Position Desired:

How did you hear about the position?

Will you work overtime if asked?

YesNo

Pay Expected:

Are you 18 years of age or older?

YesNo

Do you have reliable transportation?

YesNo

    When will you be available to work?

Education Background:

Highschool:

    Highest Grade Completed:
    9101112/GED

Major Area of Study:

College:

Major Area of Study:

Trade/Business/Graduate School:

Military:

Have you served in the US Armed forces?

If yes, What branch?

    Describe any training you received while in the military relevant to the position for which you are applying.

Beginning with your most recent position, list below present and past employment. All applicants must complete this section even if attaching a resume.

Position 1

Name:

Title:

Start-End Date:

Phone

Address:

City:

State:

Zip:

Starting Position

Ending Position

Reason for Leaving

Name of Supervisor

Position 2

Name:

Title:

Start-End Date:

Phone

Address:

City:

State:

Zip:

Starting Position

Ending Position

Reason for Leaving

Name of Supervisor

Position 3

Name:

Title:

Start-End Date:

Phone

Address:

City:

State:

Zip:

Starting Position

Ending Position

Reason for Leaving

Name of Supervisor

*FMCSR: Federal Motor Carrier Safety Regulations
Applicants to drive commercial motor vehicles* shall also provide a total of 10 years of information on those employers
for whom the applicant operated such vehicle. Vehicles having a GVWR of 26,001 lbs. or more, or designed to transport
15 or more passengers or any size vehicle used to transport hazardous materials in a quantity requiring placarding.
(Attach additional sheet if necessary)

    Please give an explanation for any gaps in employment:

We may contact the employers listed above unless you indicate those you do not want us to contact.

    Name of Employer(s)/Reason:

Skills and Qualifications


Summarize special skills and qualifications acquired from employment or other experiences that may qualify you to work for our company.

    List any of your relatives currently working for Johnson Lumber Company LLC

    List three references of persons who are not related or former employers (please include name, address, and phone number):

CDL DRIVER APPLICANTS ONLY COMPLETE BELOW

Driver Licenses Held in past 3 years

State:

License #:

Class:

Endorsement(s):

Expiration Date:

Date of Birth:

Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Has any license, permit, or privilege been suspended or revoked?

Have you ever been disqualified for violations of the Federal Motor Carriers Safety Regulations?

    If you answered “yes” to B, C, or D, attach a statement giving details.

Driving Experience

Type of Equipment:

VanStraight TruckTankFlatTractor/Semi-TrailerOther

Dates:

Approximate Total Miles:

    List special courses or training that will help you as a driver

    List driving awards held and who awards were presented by

Accident Review for past 3 years

Nature of Accident (Head-On, Rear-End, Overturn, etc.)

Dates:

Fatalities:

Injuries:

Location:

Charge:

Penalty:

ALL APPLICANTS MUST READ AND SIGN — APPLICATION NOT VALID UNLESS SIGNED

It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or not, and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with Johnson Lumber Company, I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job for which I am being considered. I also understand that, if offered a job, it will be conditioned on the results of a drug test, my ability to provide proper documentation of my legal right to work in the U.S. and may be condition on the results of a physical exam.

Positions which include the essential function of driving company vehicles or personal vehicles to perform company business require a valid driver’s license and an acceptable driving record. Johnson Lumber will, at least annually, request a copy of the Motor Vehicle Reports from the Motor Vehicle Administration for all employees driving on behalf of the company.

I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal.

I understand and agree that, if employed by this organization; I will abide by its rules and regulations which I understand are subject to change. I further understand that, if hired, my employment is for no definite period of time and may be terminated by either party at any time. Additionally, I understand that according to Maryland Law this employer may not require or demand, as a condition of employment, prospective employment, or continued employment, that I submit to or take a lie detector or similar test.

This application is current for 60 days. At the conclusion of the 60 days, if I have not heard from the employer and still wish to be considered for employment I will complete a new employment application.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason.


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