Employment Application

Personal Data

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Alternate Phone Number

Email Address(Required)

Have you ever worked for BLACK EQUIPMENT COMPANY before?(Required)

Yes

No

Please list the dates and position held.(Required)

Position applying for:(Required)

Parts Associate

Road Technician

Location:(Required)

Would you be willing to relocate?(Required)

Yes

No

Compensation Expected:(Required)

Compensation listed here is not guaranteed or promised. Compensation will be based upon the following including, but not limited to experience, knowledge and skill.

Availability (select all that apply):(Required)

Temporary

Part Time

Full Time

Weekends

Over time

Date You Would Be Available to Start:(Required)

Are you legally eligible for employment in this country? (Evidence of eligibility will be required upon employment.)(Required)

Yes

No

Do you have your own transportation?(Required)

Yes

No

Have you ever had your driving privileges suspended or revoked?(Required)

Yes

No

Please explain:(Required)

How were you referred to us?

Walk-In

Employee

Facebook

Job Search

Website

Other (please specify)

Name of Employee who referred you:(Required)

Other (please specify):(Required)

Do you have a Resume you would like to provide?(Required)

Yes

No

Please upload your Resume:(Required)

Max. file size: 50 MB.

References

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Years Known:(Required)

How does this person know you?(Required)

Reference 2

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Years Known:(Required)

How this person know you?(Required)

Reference 3

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Years Known(Required)

How does this person know you?(Required)

Important Agreement

Do not submit this application unless and until you have read and understand this section.

I Certify that the information contained in this application is true and complete. I authorize investigation of all statements contained in this application and understand that any false or misleading statements or material omissions are cause for separation of employment, if employed. I hereby authorize former and preset employers, except as I have otherwise indicated on this application, as well as schools, references and others to provide or verify any information they have regarding me or my employment with them, to BLACK EQUIPMENT COMPANY, INC or its representative hereinafter called “BLACK EQUIPMENT COMPANY” and release them from any liability arising from the furnishing of any such employment history or information.

I further agree and understand that, except as governed by existing Federal, State or Local law, my employment or an offer of employment establishes no guarantee of continued employment, employment for a definite duration or obligation beyond pay for actual work performed at the agreed-upon rate of pay and that the employment relationship may be terminated at any time, by myself or BLACK EQUIPMENT COMPANY at either part’s option and will,

I agree to review and become familiar with the policies of BLACK EQUIPMENT COMPANY as may from time to time be established or amended. I understand that no personnel recruiter, interview or other representative of BLACK EQUIPMENT COMPANY, other than the President of BLACK EQUIPMENT COMPANY via a signed and dated written document, has any authority to enter into any agreement for employment for any specified period of time.

Electronic Signature Acknowledgement and Consent

Please note that by signing below you agree and acknowledge that your electronic signature is the legal equivalent of your handwritten signature.

Please type your name.(Required)

Date(Required)

Personal Data

References

Reference 2

Reference 3

Skills (Office)

Important Agreement

Electronic Signature Acknowledgement and Consent

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