Oneta Employment Application

Applicant Information

First Name *

Middle Name

Last Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Phone *

Email Address *

Are you at least 21 years old? *YesNo

DRIVING POSITIONS ONLY – For Insurance Purposes: Are you at least 23 years old?YesNo

Position Applying For: *

Salary Desired: *

How did you hear about the open position? *

Are you currently employed? *YesNo

If yes, may we inquire of your present employer? *YesNo

Have you ever been employed by Oneta Company before?YesNo

If yes, When?

Department:

Supervisor Name:

Why did you leave Oneta Company?

Do you have any friends or relatives working for the Company? *YesNo

If yes, name(s) and relationship(s)

If applicable, name of Oneta Company Employee that referred you? *

Please fill out the hours and the days you are available to work below. *

Type of Work Desired *

Available start date: *

Military Service

Branch

Rank at Discharge

Date From

Date To

Type of Discharge

If other than honorable, please explain

If driving is a requirement of the job for which you are applying, continued employment is contingent on maintaining a valid driver’s license.

Do you have a valid drivers license?YesNo

What type of license do you have?Class C -Standard LicenseCDL Class BCDL Class A Combination

Within in the last (5) five years, do you have any traffic violations (tickets) / Accidents that would prevent you from driving for our company?YesNo

If you answered yes to the last question, please list the dates and type of violaiton.

Are you able, at the time of employment, submit verification of your legal right to work in the U.S.? *Verification and completion of the I-9 form must be submitted no later than three business days after date of hire.YesNo

Within the last (7) seven years, have you under your name or another name, been convicted of a crime, misdemeanor, or felony, convicted of or pleaded guilty or nolo contendere to a criminal offense, misdemeanor, or felony other than a minor traffic violation?YesNo

If you answered yes to the last question please give dates and the nature of the offense.

Convictions or existence of a criminal record does not constitute an automatic bar to employment.

Education Training and Experience

Education Level

School Name

Years Completed

Degree or DiplomaYesNo

Major area of study

Please list your areas of highest proficiency, technical/specialized certifications, computer experience, (ex: Microsoft Office, Excel), or other skill-sets which may contribute to your abilities in performing the above mentioned position

Employment History:Please provide at least 10 years of working experience, most recent first, if applicable.

Please provide at least 10 years of working experience, most recent first, if applicable.

Employment History

Company *

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Supervisor *

Job Title

Responsibilities

Employment From *

Employment To *

Month

Day

Year

Starting Salary

Ending Salary

Reason For Leaving

Explain all Gaps of employment: Provide dates.