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Employment Application

Please fill out the form below to apply for employment with Reliable Underground Service Technicians (RUST).

* Indicates A Required Field

SECTION 1 - Contact Information
* Your Name
* Middle Name
* Last Name
* Phone Number
* Your Email

* Address
* City
* State
* Zip Code

* Are you 18 years or older? YesNo

* Are you prevented from lawfully becoming employed in this country because of visa or immigration status? YesNo

SECTION 2 - Employment Desired
* Position
* Date you can start
* Salary Desired

* Are you employed now? YesNo

* May we contact your present employer? YesNo

* Ever applied to this company before? YesNo

Where
When
Referred by
SECTION 3 - Education

GRAMMAR SCHOOL

Name & Location of School
Subjects Studied
# Years Attended
Did you graduate?
YesNo

HIGH SCHOOL

Name & Location of School
Subjects Studied
# Years Attended
Did you graduate?
YesNo

COLLEGE

Name & Location of School
Subjects Studied
# Years Attended
Did you graduate?
YesNo

TRADE, BUSINESS OR CORRESPONDENCE SCHOOL

Name & Location of School
Subjects Studied
# Years Attended
Did you graduate?
YesNo

GENERAL
Subjects of Special Study or Research Work

Special Skills

Activities (Civic, Athletic, Etc.)
Exclude organizations, the name of which indicates the race, creed, sex, age, marital status, color or nation of origin of its members.

U.S. Military or Naval Service
Rank
Present National Guard/Reserves Membership
SECTION 4 - Employment history

(list below last three employers, starting with last one first).

Name & Address of Employer
Salary
Position
Reason for Leaving
From (Month, Date & Year)
To (Month, Date & Year)

Name & Address of Employer
Salary
Position
Reason for Leaving
From (Month, Date & Year)
To (Month, Date & Year)

Name & Address of Employer
Salary
Position
Reason for Leaving
From (Month, Date & Year)
To (Month, Date & Year)

Which of these jobs did you like best?

What did you like most about this job?

SECTION 5 - References

Give the names of three persons not related to you, whom you have known at least one year.

* Name
* Address
* Business
* Years Acquainted

* Name
* Address
* Business
* Years Acquainted

* Name
* Address
* Business
* Years Acquainted

SECTION 6 - Applicants Certification & Agreement

"I certify that all the information submitted by me on this application is true and complete, and I understand that If any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed. My employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause. And with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

* Do you agree with the terms of employment?
YesNo

* Name
* Date

Additional Notes

RUST Affiliates