Careers

Personal Information
First Name*
Last Name*
Your Email Address*
Your Phone Number*
Address*
Street Address City State ZIP Code

Times available to work each day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Referral Source
Referral Source
If Other, explain

Personal References
List two personal references not related to you and not employed by Francis and Sons
Name
Relationship
Phone
Email
Name
Relationship
Phone
Email

Education
Highest grade completed:
Name of last school attended

Employment History (Most recent or current employer)
Employer
Name of Supervisor
Employer Address
Employer City
Employer Phone
Employment Period
Date Format: MM slash DD slash YYYY
Employment Period
Date Format: MM slash DD slash YYYY
Type of Work Performed
Starting Salary
Present or Last Salary
Reason for leaving

Employment History Employer 2)
Employer
Name of Supervisor
Employer Address
Employer City
Employer Phone
Employment Period
Date Format: MM slash DD slash YYYY
Employment Period
Date Format: MM slash DD slash YYYY
Type of Work Performed
Starting Salary
Present or Last Salary
Reason for leaving

Military Experience
Dates of Service
Date Format: MM slash DD slash YYYY
Dates of Service
Date Format: MM slash DD slash YYYY
Armed Forces Type
Rank
If you served in the US Armed Forces, briefly describe the skills you acquired

Additonal Information
Do you speak a language in addition to English
- Yes
- No
If yes, explain
Are you legally authorized to work in the United States?
- Yes
- No
Do you have a current valid drivers license?
- Yes
- No
License Number
Address
State
Expiration Date
Date Format: MM slash DD slash YYYY
Note: Answering YES to the below questions does not automatically disqualify you for employment
Have you ever pled "guilty" or "no contest" to a crime or been convicted of a crime?:
If yes, give date and details:
Have you ever been convicted of a DUI or DWI?
- Yes
- No
If yes, Date

Employment Application Agreement
I certify that the answers given by me to the foregoing questions and statements are true and correct to the best of my knowledge without consequential omissions of any kind.
I agree that the Company shall not be held liable in any respect if my employment is rejected or subsequently terminated because of false statements, answers or omissions made by me in this application.
I understand that any misleading or incorrect statements may render this application void, and if employed, may lead to employment termination.
I understand that a medical examination based on the requirements of the position for which I am being considered may be required, and drug testing may be included as part of the regular pre-employment physical.
I also voluntarily and knowingly authorize the companies, schools or persons named above to give any information requested regarding my former employment, character and qualifications.
I hereby voluntarily and knowingly fully release and discharge, absolve, indemnify, and hold harmless said companies, schools or persons from any and all liability for any damages for issuing this information, except for the malicious and willful disclosure of derogatory facts concerning my employment made for the express purpose of preventing me from obtaining employment, which the party disclosing such facts knows to be untrue.
In consideration of my employment, I agree to conform to the rules and regulations of this organization. I understand that employment with Francis and Sons. is at-will, meaning that my employment and compensation can be terminated with or without cause and with or without notice, at any time, at the option of either my employer or myself. While employment policies or procedures may change from time to time, only a written agreement signed by the company's president can change the employee's at-will status.
I agree*
- I agree to the terms of this employment application

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