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Employment Opportunities

APPLICATION FOR EMPLOYMENT


This application is not an employment contract, but merely is intended to provide information necessary to evaluate suitable for employment. It is the policy of BMC to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, martial status, national origin, citizenship, disability, genetic information, veteran status, or any other status protected under state or federal law. It is also the policy of BMC to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a medical examination, which may include a drug test or other physical evaluations. This application will remain active for 180 days.

PERSONAL INFORMATION

( PERSONAL INFORMATION ) Name (Last, First, Middle)*

( PERSONAL INFORMATION ) Referred by

( PERSONAL INFORMATION ) Home Phone

( PERSONAL INFORMATION ) Work Phone

( CURRENT ADDRESS ) Address Line 1

( CURRENT ADDRESS ) Address Line 2

( CURRENT ADDRESS ) City

( CURRENT ADDRESS ) State

( CURRENT ADDRESS ) Zip Code

( PREVIOUS ADDRESS 1) Address Line 1

( PREVIOUS ADDRESS 1) Address Line 2

( PREVIOUS ADDRESS 1) City

( PREVIOUS ADDRESS 1) State

( PREVIOUS ADDRESS 1) Zip Code

( PREVIOUS ADDRESS 2 ) Address Line 1

( PREVIOUS ADDRESS 2 ) Address Line 2

( PREVIOUS ADDRESS 2 ) City

( PREVIOUS ADDRESS 2 ) State

( PREVIOUS ADDRESS 2 ) Zip Code

( EDUCATION ) High School Attended

( EDUCATION ) City

( EDUCATION ) County

( EDUCATION ) State

( EDUCATION ) Did you earn a diploma?

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( EDUCATION ) Undergraduate Attended

( EDUCATION ) City

( EDUCATION ) State

( EDUCATION ) Areas of Study

( EDUCATION ) Degree/Certification/Diploma

( EDUCATION ) Graduate School Attended

( EDUCATION ) City

( EDUCATION ) State

( EDUCATION ) Areas of Study

( EDUCATION ) Degree/Certification/Diploma

( EDUCATION ) Trade, Business, Other School Attended

( EDUCATION ) City

( EDUCATION ) State

( EDUCATION ) Areas of Study

( EDUCATION ) Degree/Certification/Diploma

( EMPLOYMENT INFORMATION ) Position Applied For

( EMPLOYMENT INFORMATION ) Desired Salary

( EMPLOYMENT INFORMATION ) What hour you are available to work?

( EMPLOYMENT INFORMATION ) Can you work

( EMPLOYMENT INFORMATION ) Are you at least 18 years of age and legally eligible for work in the United States?

( EMPLOYMENT INFORMATION ) Will you work overtime when necessary?

( EMPLOYMENT INFORMATION ) Will you work overtime when necessary?

( EMPLOYMENT INFORMATION ) Have you ever been discharged or asked to resign from a job?

( EMPLOYMENT INFORMATION ) If yes, please explain

( REFERENCES ) Please list the names of three persons not related to you, whom you have known at least one year.

( REFERENCES ) Phone Number

( REFERENCES ) Business

( REFERENCES ) Years Acquainted

( REFERENCES ) Name

( REFERENCES ) Phone Number

( REFERENCES ) Business

( REFERENCES ) Years Acquainted

( REFERENCES ) Name

( REFERENCES ) Phone Number

( REFERENCES ) Business

( REFERENCES ) Years Acquainted

( EMPLOYMENT HISTORY ) May we contact your present employer?

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( EMPLOYMENT HISTORY ) Most Recent Employer

( EMPLOYMENT HISTORY ) City

( EMPLOYMENT HISTORY ) State

( EMPLOYMENT HISTORY ) Zip Code

( EMPLOYMENT HISTORY ) Phone Number

( EMPLOYMENT HISTORY ) Position Held

( EMPLOYMENT HISTORY ) Start Date

( EMPLOYMENT HISTORY ) End Date

( EMPLOYMENT HISTORY ) Pay Rate Upon Leaving

( EMPLOYMENT HISTORY ) Supervisor

( EMPLOYMENT HISTORY ) Duties

( EMPLOYMENT HISTORY ) Reason for Leaving

( EMPLOYMENT HISTORY ) Next Most Recent Employer

( EMPLOYMENT HISTORY ) City

( EMPLOYMENT HISTORY ) State

( EMPLOYMENT HISTORY ) Zip Code

( EMPLOYMENT HISTORY ) Phone Number

( EMPLOYMENT HISTORY ) Position Held

( EMPLOYMENT HISTORY ) Start Date

( EMPLOYMENT HISTORY ) End Date

( EMPLOYMENT HISTORY ) Pay Rate Upon Leaving

( EMPLOYMENT HISTORY ) Supervisor

( EMPLOYMENT HISTORY ) Duties

( EMPLOYMENT HISTORY ) Reason for Leaving

( EMPLOYMENT HISTORY ) Next Most Recent Employer

( EMPLOYMENT HISTORY ) City

( EMPLOYMENT HISTORY ) State

( EMPLOYMENT HISTORY ) Zip Code

( EMPLOYMENT HISTORY ) Phone Number

( EMPLOYMENT HISTORY ) Position Held

( EMPLOYMENT HISTORY ) Start Date

( EMPLOYMENT HISTORY ) End Date

( EMPLOYMENT HISTORY ) Pay Rate Upon Leaving

( EMPLOYMENT HISTORY ) Supervisor

( EMPLOYMENT HISTORY ) Duties

( EMPLOYMENT HISTORY ) Reason for Leaving

( JOB-RELATED SKILLS ) Do you have a valid driver's license?

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( JOB-RELATED SKILLS ) Drivers License Number

( JOB-RELATED SKILLS ) Expiration Date

( JOB-RELATED SKILLS ) Date of Issue

( JOB-RELATED SKILLS ) Have you ever been convicted of or pled guilty to any traffic-related offense within the past five years?

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( JOB-RELATED SKILLS ) Have you ever had your driver's license suspended or revoked?

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( JOB-RELATED SKILLS ) Have you had your driving privileges modified by a court of law?

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( JOB-RELATED SKILLS ) Please list all states from which you hold or have held a driver's license

( JOB-RELATED SKILLS ) Please use this space to list any special skills you may have that relate to the position applied for

( JOB-RELATED SKILLS ) Please list any professional licenses, designations, certifications, etc. that may relate to the position applied for (please include date granted, name of organization, any other relevant information)

APPLICANT'S CERTIFICATION AGREEMENT 1) I certify that the facts and information set forth in this application are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of facts on this application (or on any required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how it was discovered. 2) I authorize the investigation of all statements contained in this application and release from all liability any persons or employers supplying such information, and I also release the company from all liability that might result from making the investigation. 3) If I am offered and accept a position, I agree to conform to all existing and future company rules and regulations and I understand that the company reserves the right to change wages, hours, and working conditions as deemed necessary. I ALSO UNDERSTAND THAT, IF HIRED, MY EMPLOYMENT WILL BE AT-WILL, MEANING THAT EITHER PARTY CAN END THE EMPLOYMENT RELATIONSHIP AT ANY TIME AND FOR ANY OR NO REASON. 4) I understand that any employment offer is contingent upon my providing, within three (3) working days of employment, valid proof or identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986. I have read and review the information provided in this application and the above statements. By agreeing, I certify that I understand all parts of this application and have answered all questions completely and fully.

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Date Completed


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