Employment Application
Standlee Hay Company is an equal opportunity employer

No action can be taken on this application until all questions have been answered fully and accurately.

All information given will be available only to persons who have a “need to know” or as required by law.

This company will make reasonable accommodation in the application process, if needed.

Your application will be kept on file for 30 days.

If you wish to still be considered for employment after this time, a new application will need to be submitted.
Applicant Information
Last Name First Name M.I. Date  
Address Line 1 Address Line 2 City State Zip
Phone # E-mail Address            
Date Available Desired Salary            
Position Applied For                
Are you authorized to work in the U.S.                
Have you ever worked for this company? If so, when?            
Have you ever been convicted of a felony? If yes, explan            
Education
High School Address            
Did you graduate? Degree            
 
College Address            
Did you graduate? Degree            
 
Other Address            
Did you graduate? Degree            
References
Full Name Relationship Company Phone Address
Full Name Relationship Company Phone Address
Full Name Relationship Company Phone Address
Current/Previous Employment
Company Phone Address Supervisor Job Title
Starting Salary Ending Salary Responsibilities From To
Reason for Leaving May we contact your previous supervisor for a reference?            
 
Company Phone Address Supervisor Job Title
Starting Salary Ending Salary Responsibilities From To
Reason for Leaving May we contact your previous supervisor for a reference?            
 
Company Phone Address Supervisor Job Title
Starting Salary Ending Salary Responsibilities From To
Reason for Leaving May we contact your previous supervisor for a reference?            
EEOC Registration
Applicants and employees are treated without regard to race, color, religion, gender, national origin, age, veteran status, disability or any other legally protected status during every aspect of the employment process.

As employers and government contractors, we comply with government regulations and affirmative action responsibility. Solely to help us comply with affirmative action record keeping, reporting and other legal requirements, please complete the survey below. This information will not be used for hiring, placement, or other decisions related to the terms and conditions of employment. This document will be kept in a confidential file, separate from applicant and personnel files.

Your cooperation is voluntary. Inclusion or exclusion of any data will not affect any employment decision.

Birthdate: MO DAY YEAR
Gender: Male or Female
Ethnicity/Race:
American Indian or Alaska Native
Asian
Hispanic or Latino
Black or African American
Hawaiian Native or other Pacific Islander
White
Other
Decline Response

Definitions:

  • White (Not of Hispanic origin) All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.
  • Black or African American- All persons having origins in any of the Black racial groups of Africa.
  • Hispanic or Latino- All persons of Mexican, Puerto Rican, Cuban Central or South American, or other Spanish culture or origin, regardless of race.
  • Asian or Pacific Islander- All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samos.
  • American Indian or Alaskan Native- All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.


Disabled: yes no US Veteran: yes no Disabled US Veteran: yes no
Armed Forces Service - Medal Veteran: yes no -- Newly Seperated: yes no
Disclaimer and Signature
This Employment Application is used to notify me that the nature and scope of an investigation, if one is conducted, could include such general identification information as residence verification, and as applicable, information concerning my employment, education, general reputation, character, personal characteristics, and habits. This information may be developed through personal interviews with third parties such as family members, neighbors, friends, associates, former employers, educational institutions, and custodians of official records or other sources. Only job related information developed from such a report will be considered in evaluating my employment application or continued employment. I hereby authorize these persons, companies, organizations or corporations to answer all questions or release any information regarding the items listed in this paragraph. I hereby release them fro any liability and hold them harmless from any claim for releasing any truthful information within their knowledge and/or records.

I authorize Standlee Hay Company to release to any person, firm, entity or organization with which I may seek future employment, any truthful information concerning my work experience with the Company. I hereby release and hold the Company harmless from any claim for releasing any truthful information within its knowledge and/or records.

I understand that any job offer that may be extended to me may be contingent upon the successful completion of a drug and alcohol test.

I certify that the answers given by me to the foregoing questions and during any interview are true and correct without consequential omissions. I understand that if employed omissions and/or false statements on this application or during any interview may result in dismissal. I understand and acknowledge that if hired, my employment is for no definite period and either the Employer or I may terminate our relationship at will at any time, without notice or for any reason. This employment application does not constitute an employment contract between me and the Company. I have had an opportunity to have my questions about this statement’s content and intent answered. I understand its terms and agree to them.
Signature (Type Your Full Name) Date