Employment Application Form

We’re looking for people to join the team!

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We Are An Equal Opportunity Employer.

Applicants are considered for all positions without regard to race, religion, sex, national origin, disability, age or ancestry.

PERSONAL INFORMATION

First Name(Required)

Last Name(Required)

Date of Birth(Required)

Applicant Email(Required)

Enter Email Confirm Email

Applicant Address(Required)

Street Address Address Line 2 City State ZIP Code

Your Primary Phone #(Required)

Alternate Phone #

Best Time To Call You

Positions applying for(Required)

Salary/Rate Expected

Date available?(Required)

MM slash DD slash YYYY

Who referred you to us for employment?

Available For:(Required)

(Please circle all that apply)

Full Time

Part Time

Shift Work

Temporary

Have you applied at OSCO before?(Required)

Yes

If yes, when?

Were you employed by OSCO before?(Required)

Yes

If yes, when?

Are you presently legally authorized to work in the United States on a full-time basis?(Required)

Yes

Have you ever been charged or convicted of a criminal offense other than a minor traffic violation?(Required)

Yes

If yes, when?

Where / Jurisdiction

Please Explain

A CONVICTION RECORD WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT, AND FACTORS SUCH AS YOUR AGE AT THE TIME OF THE OFFENCE, THE SERIOUSNESS AND NATURE OF THE VIOLATION, AND THE NATURE OF THE JOB FOR WHICH YOU ARE APPLYING WILL BE TAKEN INTO ACCOUNT.

Do you currently use tobacco?(Required)

Yes

Have you used tobacco at any time during the past 6 months?(Required)

Yes

EDUCATION

What is the highest level of education completed? (List the most recent first.)

Name of School(Required)

School Address

School Level

Course of Study

Years Completed

Grade Point Average

Name of School

School Address

School Level

Course of Study

Years Completed

Grade Point Average

Add Another Education?

Yes

Name of School

School Address

School Level

Course of Study

Years Completed

Grade Point Average

EMPLOYMENT

List your three most recent employers (Most recent first). Do not omit any employment.

Employer Name(Required)

Employer Address

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Immediate Supervisor

Telephone

Nature of Duties and Job Held

Reason for Leaving

Employer Name

Employer Address

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Immediate Supervisor

Telephone

Nature of Duties and Job Held

Reason for Leaving

Employer Name

Employer Address

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Immediate Supervisor

Telephone

Nature of Duties and Job Held

Reason for Leaving

Add Another Employer?

Yes

Employer Name

Employer Address

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Immediate Supervisor

Telephone

Nature of Duties and Job Held

Reason for Leaving

REFERENCES

Name

Phone

Profession or Title

How Long Known?

Address

Name

Phone

Profession or Title

How Long Known?

Address

Name

Phone

Profession or Title

How Long Known?

Address

MILITARY EXPERIENCE

Prior Military Service

Do you have any prior military service?

Yes

Date Entered

MM slash DD slash YYYY

Branch

Date Discharged

MM slash DD slash YYYY

Was Discharge Honorable?

WHO SHOULD WE CONTACT IN CASE OF AN EMERGENCY?

Name(Required)

Phone(Required)

Relationship(Required)

Name

Phone

Relationship

ACKNOWLEDGEMENT

Read carefully before signing(Required)

I UNDERSTAND THAT THIS APPLICATION DOES NOT CONSTITUTE AN EMPLOYMENT CONTRACT OR AN OFFER FOR EMPLOYMENT FROM OSCO. I FURTHER UNDERSTAND THAT IF OSCO OFFERS ME A POSITION OF EMPLOYMENT, MY EMPLOYMENT WILL BE "AT WILL" AND THAT EITHER I OR THE COMPANY MAY TERMINATE THE EMPLOYMENT AT ANY TIME FOR ANY REASON. I UNDERSTAND THAT I MUST AT ALL TIMES ABIDE BY THE COMPANY'S RULES AND REGULATIONS.

I AUTHORIZE OSCO TO INVESTIGATE ANY STATEMENTS MADE IN THIS APPLICATION AND AUTHORIZE THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE OSCO ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE. I FURTHER RELEASE AND AGREE TO HOLD HARMLESS OSCO, AGENTS OF THE COMPANY, OR ANY OTHER PARTY IN INTEREST, AND ALL PARTIES PROVIDING INFORMATION FROM ALL LIABILITY FOR ANY CLAIM OR DAMAGE THAT MAY RESULT FROM FURNISHING SUCH INFORMATION TO OSCO.

I UNDERSTAND THAT UNDER OSCO'S POLICIES, ALL APPLICANTS SELECTED FOR FINAL CONSIDERATION MUST SUBMIT TO AND PASS A ROUTINELY ADMINISTERED "PRE-EMPLOYMENT DRUG SCREENING" EVALUATION BEFORE AN EMPLOYMENT OFFER WILL BE MADE. FAILURE OF THIS DRUG SCREENING WILL RESULT IN THE APPLICANT'S IMMEDIATE DISQUALIFICATION FOR EMPLOYMENT AT OSCO INDUSTRIES, INC.

I CERTIFY THAT THE INFORMATION I HAVE GIVEN ON THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT ANY FALSE INFORMATION PROVIDED ON THIS APPLICATION OR AT THE TIME OF THE INTERVIEW(S) OR ANY FAILURE TO DISCLOSE INFORMATION REQUESTED ON THIS APPLICATION OR DURING ANY INTERVIEW SHALL BE CAUSE FOR IMMEDIATE DISCHARGE.

I agree

Hidden

Applicant's Signature

Signature

Date

MM slash DD slash YYYY

Hidden

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Employment Application Form

We’re looking for people to join the team!

PERSONAL INFORMATION

EDUCATION

EMPLOYMENT

REFERENCES

MILITARY EXPERIENCE

WHO SHOULD WE CONTACT IN CASE OF AN EMERGENCY?

ACKNOWLEDGEMENT

CREDIT INFORMATION