Application for Employment

EMPLOYMENT APPLICATION


We offer equal opportunities to all persons without regard to race, color, religion, sex, age, national origin, disability and veteran or any other legally protected status.

PERSONAL INFORMATION

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List addresses of residency for past 3 years.
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EDUCATION

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REFERENCES

Do not list relatives or previous employers
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EMPLOYMENT HISTORY


List each job held, starting with your most recent or current employer. Include military service assignments. All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years.

Applicants to drive a commercial motor vehicle* intrastate or interstate commerce shall also provide an additional 10 years information on those employers for whom applicant operated such vehicle.


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EMPLOYER TWO

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EMPLOYER THREE

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EMPLOYER FOUR

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* Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

** The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport 9 or more passengers, OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

AGREEMENT AND CERTIFICATION

I certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial or employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation and previous employment record. I release all such persons from any liability or damages on account of having furnished such information.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Fred Taylor Company, Inc. and Subsidiaries (hereinafter FTC) and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon FTC unless made in writing. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that FTC retains the same right.

I understand that prior to being offered employment with FTC I may be requested to take an examination. In the event I have a disability which will affect my ability to take the test, I will so inform FTC prior to the administration of the test so that a reasonable accommodation can be made. Requested accommodations may include accessible testing sites, modified testing conditions, and accessible testing formats. FTC reserves the right to require medical documentation concerning the need for the accommodation. I further understand if an offer of employment is tentatively made to me, it is conditioned upon my successful completion of a medical examination, which may include screening for Controlled substances, from time to time during my employment.

I authorize FTC to make such investigations and inquires of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

I understand the information I provide regarding current and/or previous employers may be used, and those employers will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

• Review information provided by previous employers. • Have errors in the information corrected by previous employers and for those previous employers to resend the corrected information to the prospective employer; and • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

I understand if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies or procedures, in whole or in part, at any time.

My signature hereon certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

I understand that this application will be kept on active file for 30 days from the date completed, after which time I would have to reapply in accordance with company procedures.

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Contact Us

Corporate Headquarters
2700 Palmyra Road
Albany, Ga. 31707
229-883-7250

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