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linen cleaned to date
 

 
 
Application For Employment
An Equal Opportunity/Affirmative Action Employer
Date:

To Bates Troy, Inc.
I do hereby make application for employment in such a position that you may see fit to place me, with the understanding that if I am employed, you reserve the right to release me without notice upon payment of salary through the last day worked; and I further understand that this right to release me cannot be changed or modified except by written agreement signed by an authorized representative of the Company.
Position Desired:
Production Retail Driver
Name In Full:
Address:
Street:
City:
State:
Zip Code:
How Long at Current Address:
Telephone No:
Social Security No:
Employment Desired:
Full-Time Only Part-Time Only Full-or-Part-Time
Days/Hours Available To Work:
No Preference
Mon
Tues
Wed
Thurs
Fri
Sat/Sun
Salary Desired:
How many hours can you work weekly?
Previous Employment:  
Date:
Name, Address,
Telephone of Employer
Position
 Held
Salary
Reason for
Leaving
From
To
Start
Close
Have you ever been discharged or requested to resign?
Yes No
If so, state from whom and why:
  An Application sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualification for the specific position for which you are applying.
 
Education:
School
Address
No. Yrs.
Course of Study
Did you Graduate?

 

Reference:

Give the names of three adults who have know you for at least five years. Do not list pervious employers, relatives or more than one of your teachers.
Name
Address/Telephone#
Occupation
Yrs.Known
Have you ever been convicted of (or plead guilty)to a crime?
Yes No
If yes, give details:
Have you ever entered into a pre-trial diversion program related to a crime?
Yes No
If yes, give details:
Do you have any relatives employed by Bates Troy?
Yes No
If so, Please state whom:
May we contact your present employer?
Yes No
Did you complete this application yourself?
Yes No If not, Who did?
   

By typing my full name and initials below, I affirm that I have not withheld any information asked for in this application, and that, to the best of my knowledge and belief, the statements made herein are true and correct. I hereby authorize you to enquire as to my record of any or all former employers and references.

I understand that I may be tested for illegal drugs and I agree and authorize such testing as a condition to any offer of employment.
First Name:
Middle Name:
Last Name:  (If none leave blank)
Initials:
Employment Application Self-Identification Form
The following information is being requested for Government reporting purposes only. The information that you supply will not be used in our selection decision. Your submission of this information is optional. Failure to provide the information will not be used against you.
 
Date:
Name:
Position Applied for:
Search No:
Referred by:
Gender:

Female         Male
Race:
Hispanic or Latino White
Black or African American Asain
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Two or More Races (Not Hispanic or Latino)
(If you are a Protected Veteran, please check the box that applies to you and write in your discharge date.)
Other Protected Veteran Disabled Veteran Armed Forces Service Medal Veteran
   
Recently Separated Veteran
 Vietnam Era Veteran
           
           
Definitions:
Disabled Veteran - a veteran of the US military, ground, naval or air service who is entitled to compensation under laws administered by the Secretary of Veteran Affairs, or a person who was discharged or released from active duty because of a service related disability
Other Protected Veteran - a veteran who served on active duty in the US military, ground, naval or air service during a war or in a campaign badge has been authorized, under the laws administered by the Department of Defense
Recently Separated Veteran - any Veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval or air service.
Armed Forces Service Medal- any veteran who, While serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Veteran of the Vietnam Era- person who served on active duty for a period fo more than 180 days, and was discharged or released there from with other than dishonorable discharge, if any part of such active duty occureed in the Republic of Vietnam between 2/28/61, and 5/7/75, or between 8/5/64 and 5/7/75 in all other cases.
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Hispanic or Latino - A person of Cuban, Mexian, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

White (Not Hispanic or Latino)-A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)- A person having origins in any of the peoples of Hawaii,Guam, Samoa, or other Pacific Islands.
Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the East, Southeast Asia, or the Indian Subcontinent, including, foe example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native(Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Lation) - All persons who identify with more tahn one of the above five races.
   
  Click here to download a printable version of this application
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