Job Application

Gorman Haulage is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Please fill out all of the sections below:

Applicant Information

Applicant Name Address City State ZIPCode Phone Email Application Date

Employment Position

What position are you applying for? How did you hear about this position? What days are you available to work? What hours or shift are you available for work? If needed, are you available to work overtime? On what date can you start working if you are hired? Do you have reliable transportation to and from work? Salary desired?

Personal Information

Are you 18 years of age or older (yes or no) Are you a U.S. citizen or approved to work in this country (yes or no) What document can you provide as proof or citizenship or legal status Will you consent to mandatory controlled substance testing (yes or no) Do you have any condition which would require job accommodations? (yes or no) If yes, please describe accommodations required: Have you ever been convicted of a criminal offense (felony or misdemeanor)? (yes or no) If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:

Job Skills/Qualifications

(Note: Gorman Haulage complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)

Please list below the skills and qualifications you possess for the position you are applying:

Education and Training

High School Location (City, State) Year Graduated Degree Earned College/University Location (City, State) Year Graduated Degree Earned Vocational School/Specialized Training Location (City, State) Year Graduated Degree Earned

Military

Are you a member of the Armed Forces? (yes or no) What branch of the military did you enlist? What was your military rank when discharged? How many years did you serve in the military What military skills do you possess that would be an asset for this company?

Previous Employment

Employer Name: Job Title Supervisor Name: Employer Address (street/city/state/zip code) Employer Telephone Number Dates Employed Reason for leaving: Employer Name: Job Title: Supervisor Name: Employer Address (street/city/state/zip code) Employer Telephone Number Dates Employed: Reason for leaving:

References

Please provide 3 personal and professional reference(s) below:

Reference and Contact Information: Reference and Contact Information: Reference and Contact Information:

AT-WILL EMPLOYMENT

The relationship between you and the Gorman Haulage is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with our without cause, with or without notice, by you or the Gorman Haulage. No representative of Gorman Haulage has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.

Applicant Signature (type full name to sign) Today's Date:

Job Application

Services

Job Application

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

Military

Previous Employment

References

AT-WILL EMPLOYMENT

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Job Application

Services

Job Application

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

Military

Previous Employment

References

AT-WILL EMPLOYMENT

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