EMPLOYMENT APPLICATION

 

* Indicates Required Field




(dd/mm/yyyy)









Yes     No

Yes     No


Yes     No


Yes     No

 


EMPLOYMENT RECORD (list most recent job first)


Yes     No

 









Dates of employment:










Dates of employment:










Dates of employment:


DRIVING RECORD


Yes No



Yes No


Yes No

I certify that the answers above are true and correct to the best of my knowledge. I give NEI GLASS, Inc. permission to verify this information, and release all persons, including NEI GLASS, Inc. and its affiliates with respect to any information provided by prior employers or personal references. I acknowledge that if any information in this application is untrue, I may be terminated. I understand that if I am employed, my continued employment is at all times subject to the policies and procedures established by NEI GLASS, Inc. from time to time, and that my employment may be terminated at any time by me or by NEI GLASS, Inc. with or without cause. I understand that any offer of employment to me is conditioned upon my furnishing all documents required by law to be furnished to an employer, and my ability to perform all of the essential elements of my job with reasonable accommodation.