Employment Interest Form

Name *
Job Location *
(Select as many locations as you'd like)
Phone *
Did You Graduate?
Did you Graduate?
List three persons not related to you who have knowledge of your work performance within the last five years.
1. Reference
1. Reference
1. Phone
1. Phone
2. Reference
2. Reference
2. Phone
2. Phone
Please list below the last five years of employment history, starting with the most recent. Account for all periods of employment, even if attaching a resume.
1. May we contact this employer for a reference?
2. May we contact this employer for a reference?
3. May we contact this employer for a reference?
Have you ever worked for Taylor Trim & Supply, Inc. before?
Do you have any friends or relatives currently working for Taylor Trim & Supply, Inc.?
If hired, would you have a reliable means of transportation to and from work?
Are you at least 18 years old?
If under 18, do you have a work permit?
If hired, can you present evidence of your US citizenship or proof of your legal right to live and work in this country?
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application *
I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I hereby authorize Taylor Trim & Supply, Inc. to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and further authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure.
In addition, I hereby release the Company, my former Employers, and all other persons, corporations, partnerships and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigating or disclosure.
I understand that nothing contained in the application, or conveyed during any interview or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice at the option of either myself or the Company.
Also, I understand that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by myself and the Company's designated representative.
Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgement) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I mark the check box below.
If I am not hired as a result of such information, I am entitled to a copy of any such records, even though I have checked the box below.
How did you hear about us?