Employment – Michael B. Stoner, Inc.

MB Stoner Inc. Digital Job Application

Contact Info

First Name *

Middle Initial/Name *

Last Name *

Address *

Country

City

State

Zip code

Email *

Phone *

Date of Birth *

mm/dd/yy

Desired Wage *

Personal Information

Are you legally authorized to work in the United States? *

Proof of U.S. citizenship or immigration status is required if hired.

Yes

If you are under age 18, can you furnish a work permit? *

Yes

Have you been convicted of or pleaded no contest to a felony within the last five years? *

If yes, please explain:

Yes

Are you a veteran? *

If yes, give dates of service:

Yes

Position/Availability

Position Applying For:

Hours Available *

Explain hours available on days selected above.

Are you seeking full time, part time, or temporary employment? *

Full Time

Part Time

Temporary

What date are you available to start work? *

mm/dd/yy

Have you ever worked for this organization before? *

If yes, list dates

Yes

List any friends or relatives employed by this company:

If hired, do you have a reliable means of transportation to get to work? *

Yes

Are you currently working as of today? *

Yes

Education

Name and city, state of schools, colleges - degree/diploma

Skills and Qualifications: Licenses, skills, Training, Awards, etc.

Any additional comments

Employment History

Employer1 Name

Employer1 Phone

Employer1 Address

Apt, suite, etc.

Country

City

State

Zip code

Employer Address

From:

Start of Employment

To:

End of Employment

Salary:

Enter Last Salary

Responsibilities:

Reason for Leaving:

May we contact your present employer?

Yes

Employer 2

Employer2 Name

Employer2 Phone

Employer2 Address

Apt, suite, etc.

Country

City

State

Zip code

Employer Address

From:

Start of Employment

To:

End of Employment

Salary:

Enter Last Salary

Responsibilities:

Reason for Leaving:

Feedback

How did you find out about employment at M.B. Stoner, Inc.?

Authorizations & At-Will Employment Agreement

Authorizations

I certify that I have personally completed this application. I declare that the information provided in this employment application is true and complete and I understand that any false information or significant omissions may disqualify me from further consideration for employment and may be justification for my dismissal from employment if discovered at a later date. I agree to immediately notify this company if I should be convicted of a crime while my job application is pending or during my employment, if hired.

I authorize this company to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge.

I specifically authorize and direct my current and former employers to supply employment-related information to this company and do hereby release my current and former employers from liability for providing information to this company.

Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer.

I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investigative report deemed necessary through various third party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations. I hereby agree to submit to any drug test required of me, whether prior to my employment or if employed by this company at any time thereafter. If requested, I will take a post-job offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician.

SMS TEXTING TERMS AND CONDITIONS

By signing up for text messages, you agree to receive informational messages (appointment reminders, account notifications, etc.) from Michael B. Stoner, Inc. at the number provided. Message frequency varies. Msg & data rates may apply. If you require assistance, reply HELP, or you can call (717) 245-2225 or email us at michael@stonerinc.net to reach our office. You can opt-out at any time by replying STOP. View our Privacy Policy

AT-WILL EMPLOYMENT AGREEMENT

I understand and agree that nothing contained in this application, or conveyed during any interview is intended to create an employment contract between the company and me. In addition, I understand and agree that if you employ me, in consideration of my employment, my employment and compensation will be at-will, for no definite period of time, and may be terminated at any time, for any reason, or for no reason at all.

Please Enter Your Signature: *

Entering your name will act as your signature on this document.

And Date: *

mm/dd/yy

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