Employment Application - Dine-Aglow Diablo Food Service Fuels

Employment Application

Dine-Aglow Diablo Food Service Fuels, LLC is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Dine-Aglow Diablo Food Service Fuels, LLC makes hiring decisions based solely on qualifications, merit, and business needs at the time.

1Applicant information

2Education

3Military Service

4Employment History

5References

6Consent

Applicant Information

Position Applying For

Wage Desired

Date Available for Work

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Mobile Phone

Date of Birth

Are you a US Citizen?

Have you ever worked for Dine-Aglow Diablo Food Service Fuels, LLC before?

If yes, when?

Do you have any friends or relatives employed at Dine-Aglow Diablo Food Service Fuels, LLC or any of its divisions or subsidiaries?

If Yes, please name:

First

Last

Relation

If Yes, please name: (copy)

First

Last

Relation (copy)

If Yes, please name: (copy) (copy)

First

Last

Relation (copy) (copy)

Do you have any physical restrictions preventing specific kinds of work?

If yes, please describe the restrictions or limitations:

Have you had any serious illness or major surgery in the past 3 years?

If yes, please explain:

Have you ever been convicted of a felony?

If yes, please explain:

Education

Schools Attended:

High School
College/University
Graduate School
Trade School
Technical School
Other

Check all that apply

Hich School

Name of High School

Number of Years Attended

Major / Specialization

City and State of Institution

Did you Graduate?

College/University

Name of University

Number of Years Attended

Major / Specialization

City and State of University

Did you Graduate?

Graduate School

Name of Graduate School

Number of Years Attended

Major / Specialization

City and State of Institution

Did you Graduate?

Trade School

Name of Trade School

Number of Years Attended

Major / Specialization

City and State of Institution

Did you Complete/Graduate?

Technical School

Name of Technical School

Number of Years Attended

Major / Specialization

City and State of Institution

Did you Complete/Graduate?

Other Institution

Other Institution Name

Number of Years Attended

Major / Specialization

City and State of Institution

Did you Complete/Graduate?

Military Service

Have you ever served in the Armed Forces?

If yes, when:

From:

If yes, when:

To:

Branch:

If you served in a Technical Branch, what was your specialty?

Describe any special training

Form of Military Discharge held

Rank at time of Discharge

Employment History

Employed From

Employed To

Name of Employer

Employer's Address

Starting Position

Ending Position

Starting Salary

Ending Salary

Employer's Phone

Supervisor's Name

May we contact this employer?

______________________________________________________________________________________________________________________________________________________________________________

Employed From

Employed To

Name of Employer

Employer's Address

Starting Position

Ending Position

Starting Salary

Ending Salary

Employer's Phone

Supervisor's Name

May we contact this employer?

______________________________________________________________________________________________________________________________________________________________________________

Employed From

Employed To

Name of Employer

Employer's Address

Starting Position

Ending Position

Starting Salary

Ending Salary

Employer's Phone

Supervisor's Name

May we contact this employer?

______________________________________________________________________________________________________________________________________________________________________________

Employed From

Employed To

Name of Employer

Employer's Address

Starting Position

Ending Position

Starting Salary

Ending Salary

Employer's Phone

Supervisor's Name

May we contact this employer?

References

Please provide at least three professional references that are NOT related to you.

Name

City and State

Business and Title

Phone

______________________________________________________________________________________________________________________________________________________________________________

Name

City and State

Business and Title

Phone

______________________________________________________________________________________________________________________________________________________________________________

Name

City and State

Business and Title

Phone

______________________________________________________________________________________________________________________________________________________________________________

Name

City and State

Business and Title

Phone

Additional Information

Summarize any additional information you feel necessary such as additional work experience or personal achievements. List professional, trade, business or civic associations and any offices held.

Paragraph Text

Consent

READ CAREFULLY *

By checking the box I authorize investigation of all statements contained in this application. I understand misrepresentation or omission of facts called for is cause for dismissal. Further, I understand continuous employment is based solely on satisfactory job performance and business conditions. I agree my employment is subject to my passing of a physical examination.

POLICY REGARDING PHYSICAL EXAMINATION OF ALL APPLICANTS AND NEW HIRES *

By checking the box I understand that Dine-Aglow Diablo Food Service Fuels, LLC and/or all of its divisions and subsidiaries, requires that all new employees submit to a physical examination as a condition of permanent employment. A company appointed physician to determine your ability to perform work will perform this examination. It includes, but is not limited to, a hearing test, back examination, and the presence in blood or urine of any controlled substances, including alcohol. Failure to qualify in any of the aforementioned areas will result in an applicant being disqualified or a new hire being released from employment prior to this physical examination.

PERMISSION TO OBTAIN EMPLOYMENT INFORMATION FROM PREVIOUS EMPLOYERS AND BACKGROUND CHECK *

By checking the box I give permission to Dine-Aglow Diablo Food Service Fuels, LLC and/or any of its divisions and subsidiaries to be fully advised of my record with previous employers.
By checking the box I give permission to Dine-Aglow Diablo Food Service FueIs, LLC to perform a background check of public records.
By checking the box I hereby release Dine-Aglow Diablo Food Services Fuels, LLC and/or any of its divisions and subsidiaries as well y previous employer(s) from any and all liability of damage for providing the information requested.