Position Applied For:
Phone Numbers (Home)
Do you have any physical disabilities that could limit your effectiveness in the job applied for?
If yes, describe:
List the three most recent employers in the last 5 years:
Name and Address of Employer:
Reason for Leaving:
May we contact your previous employers?
If successful, when would you be available
Rate of pay expected per month?
Last Grade Completed:
Did You Graduate?
Name of College or Institute:
If yes, Degree in:
If no, last year completed:
Main Course of Study:
Relationship or Title:
The company has the right to terminate at any time for breach of the following confidential information: corporate methodologies, trade secrets, sales, financial or margin information, terms of employment, employee manual and any other act deemed damaging to the corporation.
The above information in my application for employment is true and complete. I understand that any false statements on this application shall be considered suffcient cause for dismissal. I understand it is the policy of Action Express Inc. to reserve the right to terminate my employment without notice within the first 90 days of my being hired, during which time I will be considered a temporary employee.
I also understand that I, as a temporary employee, have the right to terminate my employment with Action Express Inc. without notice during the first 90 days of my employment.
Print Name of Applicant in acknowledgement of above:
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