Employment Application

Personal Data


Date

First Name

Middle Name

Last Name

Street

Apt

City

State

Zip

Home Phone	- -

Cell Phone

Email
Email address will only be used for employment communication.


Are you 18 years of age or older?	Yes	No

Are you eligible to work in the United States?	Yes	No

Have you ever plead guilty or been convicted of a crime other than a driving related misdemeanor within the past 7 years?

If yes, please explain on the given line below (Conviction of a crime is not an automatic bar to employment)

Educational Data

Highest grade completed 1 2 3 4 5 6 7 8 9 10 11 12

College 1 2 3 4 Grad. School 1 2 3 4

Type of School	Name of School	City/State	Course of Study	Graduated?

Grade
High School
College
Grad. School

Material Handling Equipment Experience
( Rate Yourself, Check One)

Type of Equipment	Expert Abilities	Good Abilities	Novice/No Experience
Forklift
Electrical Jack
Order Picker
Reach Truck
Swing Reach

Computer Experience
(Check the appropriate boxes)


MS Publisher	Excel
Powerpoint	MS Outlook
Wordperfect	MS Word
Quick Books	Tracker

Other

Position Applied for: Are you available full time? Yes No

Have you ever worked for International Warehouse Group before? Yes No If yes, when

Do you have a relative working for International Warehouse Group? Yes No If yes, who?

Have you ever been dismissed or involuntarily terminated from any employment? Yes No

Employment History

Date Month and Year Most Recent employer first	Name Address Phone of Employer	Salary	Position	Reason for leaving

From To

From To

From To

From To


References
Name	Phone Number	Business	Years Acquainted


Are you able to perform the essential functions of the job(s) for which you are applying without accommodation?	Yes No

If No, please explain:


AFFADAVIT I authorize International Warehouse Group or its agents to investigate all of the information that I have provided on this employment application. I authorize any references that I have or will provide to give International Warehouse Group all information concerning my previous employment and other pertinent information they may have, personal or otherwise, and release International Warehouse Group and all references, including past employers from all liability that may result from obtaining such information. I understand that any false or misleading information provided by me on this application or during any interview may result in my not being hired or later discharged. I understand that this application does not and is not intended to create an express or implied contract of employment or to guarantee employment for any period of time. I understand that if employed, my employment is "at will" and both International Warehouse Group and I may at any time end my employment with or without reason and with or without notice. I further understand that this is a 60 day probationary period during which my performance will be evaluated. I further understand that my "at will" employment relationship may not be changed by any written document, by oral statement, or by contract unless such change is acknowledged in writing by the president of the company. This application is valid for 90 days only.