SULLIVAN EASTERN, INC.

Application for Employment

2860 C Slater Rd., Morrisville, NC 27560
Phone: 919-484-8993 Fax: 919-484-0142

Applicant Information

Full Name:

Date:

Address:apartmentUnit:

City:State:ZIP Code:

Phone:Email:

Date of Birth:

Social Security No:

Salary Desired:

Start Date:

Position Applied For:

Equipment Experience:

Legalities

Are you authorized to work in the U.S.? Yes No

Upon hire, can you provide proof of legal right to work in the U.S.? Yes No

Have you ever worked for Sullivan Eastern, Inc. before? Yes No

Have you ever been convicted of a felony? Yes No

Are you on Parole or Probation? Yes No

Do you have transportation to get to and from work? Yes No

Do you have a valid Driver’s License? Yes No

Have you had any vehicle accidents within the last 3 years? Yes No

Have you had any moving violations in the last 3 years? Yes No

Are you proficient at pulling a trailer?

Are you willing to submit to a pre-employment drug screening? Yes No

Employment Preferences

Hours Desired:

Days Unavailable: Yes No

Are you willing to work non-standard hours/overtime if needed? Yes No

Emergency Contact / Voluntary Information

Emergency Contact Name:

Emergency Contact Phone:

Relationship:

Are you over 18? Yes No

Sex:

Marital Status:

Ethnicity/Race:

Previous Employment

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:Ending Salary:

Responsibilities:

Employment From:Employment To:

Reason for Leaving:

May we contact your previous supervisor? Yes No

Military Service

Branch:

From:To:

Identification

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