Hart Employment Application Step 1 of 3 - Basic Information 0% Application for EmploymentName* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Driver's LicenseStateLicense No.License TypeExpiration DateDo you have any traffic violations/accidents for the past 3 years (other than parking violations)?*YesNoIf “yes”, list date, type of violation and penalty/chargeWould you be willing to take a Drug/Alcohol test?*YesNoDesired EmploymentPositionDate You Can StartDesired SalaryAre you employed now?YesNoIf so, may we inquire of your present employer?YesNo Name of Present or Last EmployerBusiness Name*Start Date* Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Leave this blank if you are still working for this employer.Job TitleJob DutiesAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Weekly Starting SalaryWeekly Final SalaryDescription of WorkReason for LeavingName of Previous EmployerBusiness NameStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Leave this blank if you are still working for this employer.Job TitleJob DutiesAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Weekly Starting SalaryWeekly Final SalaryDescription of WorkReason for LeavingName of Previous EmployerBusiness NameStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Leave this blank if you are still working for this employer.Job TitleJob DutiesAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Weekly Starting SalaryWeekly Final SalaryDescription of WorkReason for LeavingResume UploadAccepted file types: pdf, doc, docx, odf, txt, rtf. Policy StatementsEqual Employment It is the policy of this Company to comply with Federal and State equal employment opportunity laws. An applicant's religion, sex, sexual orientation, national origin, race, creed color, age, marital status, veteran's status and presence of a non-job related medical condition or handicap will not influence hiring, promotion, pay, benefits or any other term or condition of employment. Important factors considered for hiring of potential advancement are attitude, ability, aptitude, motivation and work quality. This Company promotes equal opportunity.Policy on HiringIt is the policy of this Company to hire only American citizens and Aliens who are authorized to work in the United States. All employees will be required to provide original documents that establish this authority within three days of their date of hire. Should the documents not be provided within that period of time, the Company has no choice, under the law, but to terminate the employee.At Will EmploymentIt is the policy of this Company that employment and compensation of any employee is at will and can be terminated with or without cause, at any time, at the option of the employee or at the option of the Company. No employee or representative of the Company other than the President, has any authority to enter into any agreement for employment contrary to the foregoing and the only if in a written, signed document. Neither this application, Employee Handbook or other agreements or conditions is to be considered a contract of employment.CertificationI hereby certify that the facts set forth in the foregoing employment application are true and complete to the best of my knowledge. I understand that falsified statements on this application or my resume, in any detail, shall be considered sufficient cause for disqualification from further consideration for hire or dismissal, whenever found.AUTHORIZATION: I hereby authorize this Company to investigate and to inquire into my employment/education/personal background. I hereby authorize any of my former employers to release information about my character and employment relationship. I agree to hold any employer of person(s) harmless for releasing information regarding my employment, education and character.AGREEMENT: I am aware that the Company has conditions of employment and policies to which I will be subject if selected for employment. I understand that my employment is "At Will". I understand that, unless otherwise specifically agreed to in writing, my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at either the Company's or my option. In this regard, I understand that such employment manuals of handbooks as may be distributed to me during the course of my employment shall not be construed to be a contract.Date Date Format: MM slash DD slash YYYY CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.
