List all your employers, starting with the current or most recent, for at least 10 years of employment. Include periods of military service, self-employment, summer, temporary or unemployment. Be sure to explain all gaps in employment in the “Comments” section at the bottom of this form.
EDUCATION & TRAINING
Bus, Tech, Trade
(Because Millennium Steel’s employees may drive their own or company vehicles or rent vehicles for company business)
Medical & Emergency Contact:
In case of emergency contact:
REFERENCES WE CAN CONTACT
Please list individuals, preferably managers, co-workers or subordinates who are qualified to evaluate your work skills, If a student, please list a recent professor. Do not include friends, relatives or individuals named in the employment section of this application.
DISCLOSURE AND AUTHORIZATION
ACKNOWLEDGMENT & AGREEMENT
I certify that I have personally completed this application and answered all questions truthfully, and have not knowingly withheld, misrepresented or omitted any information relative to this application, my resume or other attached materials. I understand to do so would result in my being eliminated from further consideration for employment. I further understand that, if accepted for employment, any misrepresentation or material omission may result in immediate termination of my employment, regardless of the time elapsed since my employment. I also understand that Millennium Steel Service may only hire only lawfully authorized workers, and that, if selected, my employment is contingent upon my ability to provide acceptable proof of my identity and employment eligibility prior to beginning employment.
I hereby authorize Millennium Steel Service or its authorized agent, to independently and thoroughly investigate all my references, complete work record, education, and all other matters related to my suitability for employment. I also authorize my former employers and references to disclose to the company any letters, reports, performance appraisals, etc. related to my work records without giving me prior notice of such disclosure. In addition, I further release the company, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
I understand that nothing contained in this application or conveyed during any interview which may be granted is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period of time and may be terminated at any time for any reason not prohibited by statute, with or without notice, at the option of myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the President of the company. If employed, I agree to read and comply with all company rules, regulations, and policies, and return all company property, materials and records immediately upon termination of my employment.
AUTHORIZATION AND RELEASE
In connection with my application for employment with Millennium Steel Service, and/or represented by its authorized agents/requesters, I understand that investigative background inquiries may be made on Myself including, but not limited to, previous employer verifications including reason(s) for terminations, education verifications, consumer credit reports, criminal convictions or history, motor vehicle reports, Social Security traces, and other reports. Further, I understand that requests may be made from Federal, State, and other agencies which maintain records concerning my past activities relating to my employment, driving, civil, criminal, worker’s compensation, and other experiences, and may include information involving me in the files of insurance companies.
I hereby authorize, without reservation, Millennium Steel Service, and/or its authorized agents, to thoroughly investigate all my references, complete work record, education and all other matters related to my suitability for employment. I also authorize my former employers, educational institutions, Federal, State and/or local agencies and any other association or institution having control of any documents, records and other information pertaining to me to disclose any and all information requested, without giving me prior notice of such disclosure.
I hereby release and forever hold harmless Millennium Steel Service and/or its authorized agents/requestors, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, actions, suits, agreements, demands, or liabilities arising out of or in any way related to such investigation or disclosure.
I understand that under Federal law, I am entitled to receive a free copy of my credit report before any adverse decision of possible employment is made because of information obtained within my credit report. Also under Federal law, I understand I am also entitled to receive a copy of my credit report at the same time the report is provided to Millennium Steel Service and that the report will be obtained from one of the following agencies: TRW, Transunion, or Equifax.
VOLUNTARY SELF-IDENTIFICATION FOR STATISTICAL REPORTING REQUIREMENTS
It is the policy of Millennium Steel Service, LLC to provide equal opportunities to qualified applicants and employees without regard to race, color, religion, national origin, citizenship, age, sex, marital status, ancestry, physical or mental disability, medical condition, veteran status, sexual orientation, or any other legally protected status. Completion of this form is entirely voluntary. It is requested solely to enable the company to meet record keeping requirements under applicable law, executive order, and regulations. The information you provide will be kept apart from your regular personnel file in a separate CONFIDENTIAL file and will not be used in consideration for any employment activity. Refusal to complete this form will not subject any applicant or employee to adverse treatment.
Millennium Steel Service may be subject to Section 503 of the Rehabilitation Act of 1973, and has pledged to take affirmative action to employ and advance in employment qualified disabled individuals. If you have such a disability, and would like to be considered under Section 503 please tell us. This information will be kept confidential, except that (a) supervisors and managers may be informed regarding restrictions on the work or duties of disabled individuals, and regarding necessary accommodations, (b) first aid or safety personnel may also be informed when and to the extent appropriate, if the condition might require emergency treatment, or (c) government officials investigating compliance with the Act.