Application for Employment

Pre-Employment Questionnaire

An Equal Opportunity Employer

PERSONAL INFORMATION
Name *
Name
Address *
Address
Phone *
Phone
Are you 18 years of age or older? *
Are you a U.S. Citizen or an Alien authorized to work in the United States? *
EMPLOYMENT at ROBERT "CHICK" FRITZ, INC.
If applying for a driver or warehouse position, do you have a Class A CDL (Commercial Driver's License)?
Are you Employed now? *
If so, may we contact your current Employer? *
Have you ever applied to Robert "Chick" Fritz, Inc before? *
EDUCATION
Did you attend Elementary School (K-8th Grade)? *
Did you attend High School? *
Did you attend a College, Trade Business or Correspondence School? *
U.S. Military Service *
Present Membership in National Guard or Reserves *
FORMER EMPLOYMENT
REFERENCES
PHYSICAL RECORD
Do you have any physical limitations that preclude you from performing any work for which you are applying for?
In Case of Emergency Contact *
In Case of Emergency Contact
Emergency Contact Phone # *
Emergency Contact Phone #
Verification of Information Provided *
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.
Today's Date *
Today's Date