General Application

In Compliance with Federal and State equal employment opportunity laws, qualified applications are considered for all positions without regard to race, color, religion, sex, national origin , age marital status, or non-job related disabilities.

 

Job Applied For

Date of Application

                   Personal Information
Name

Social Security Number
Address

Email
Address

City

State ZIP
Phone

Length of Residency

 

General Questions

Are you at least 18 years of age?
YesNo
Are you prevented from becoming employed because of visa or immigration status (If NO, be prepared to provide proof of citizenship or legal residence and work permit upon interview)
YesNo
Will you perform the essential functions of the position for which you have applied?
YesNo

Do you speak, read or write fluently a language other than English?
YesNo

If YES, describe ability and list language (s)

On what date would you be available to work

Are you available to work?

FULL TIME PART TIME SHIFT TEMPORARY

Are you on lay-off Subject to recall?
YesNo

Can you travel if the job requires it?
YesNo

If the position you are applying for involves the driving of a vehicle, do you have a valid drivers license?
YesNo

If yes Please specify the type of license:

Standard License  CDL
License Number (including - between # sets):

Expiration Date:

 

Have you had a motor vehicle accident or a moving violation in the past 3 years?

YesNo

If YES, please explain:

What types and makes of equipment  can you operate or repair, if none please indicate.

List any craft training in which you have participated, if none please indicate:

List previous Employment (List present or Last job First)

 

Dates to 
Employer
Addresses

Job Held/Duties
Wage/Rate $
reason for leaving
Dates to 
Employer
Addresses

Job Held/Duties
Wage/Rate $
reason for leaving
Dates to 
Employer
Addresses

Job Held/Duties
Wage/Rate $
reason for leaving
Dates to 
Employer
Addresses

Job Held/Duties
Wage/Rate $
reason for leaving

 

Special Skills and Qualifications

Summarize special skills and qualifications acquired from employment or other experience

Do you have your own craft tools and other equipment?
YesNo

Would you accept employment:

Out of town State wide? Unaccompanied by family?

Have you attended High school, Vocational/Technical School or College?

YesNo
If YES, please specify

    "I certify that 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, and I agree to hold my employer harmless in the event of my dismissal based thereon.

I authorize investigation of all statements contained herein and to do background checks to give you and all information concerning my previous employment and any pertinent information they have, confidential or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

I realize that under certain provisions of Iowa law, pre-employment drug testing could be a condition of my employment.  I also acknowledge that the employer may require drug testing at a subsequent time provided that proper advanced notice of testing is provided.

I also recognize that I could be offered employment subject to appropriate medical examination and that such a report could nullify my ultimate employment by this employer.  I agree to submit to physical examination if required.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the method of payment of my wages and salary, be terminated at any time without prior notice.  If employment is obtained under this application, I will comply with all the rules and policies of my employer."

I , certify that I have read and understand the preceding statement, and by marking the appropriate box I am willingly sending the above information to Illowa Investments, Inc. to be reviewed and considered on an employment basis.  

Yes, I understand No, I do not wish to apply