Application

Application

Employment Application Form

ALL NEW EMPLOYEES WILL BE TESTED FOR ILLEGAL DRUGS


Please complete all fields below.

Name:

 

 
 

 
 
Present Address:

 

 

In case of EMERGENCY

 


 

 

 

 

 

 

 

***You will NOT be denied employment solely because of a conviction record, unless the offense is related to the job for which you have applied.

 


 

Employment Desired

 

 

 

 

 

Former Employers (LIST BELOW LAST THREE EMPLOYERS, STARTING WITH LAST ONE FIRST)



 

References: (Give the names of three persons NOT related to you, whom you have known at least one year)

 

"I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED. MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.

IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM BETTS ENVIRONMENTAL RULES AND REGULATIONS AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE AT ANY TIME AT EITHER MY OR THE COMPANY’S OPTION I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAY BE CHANGED WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE AT ANY TIME BY THE COMPANY I UNDERSTAND THAT NO BETTS ENVIRONMENTAL REPRESENTATIVE OTHER THAN IT’S PRESIDENT AND THEN ONLY WHEN IN WRONG AND SIGNED BY THE PRESIDENT HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING."

I Accept!