SHORELINE WORKFORCE L.L.C.
APPLICATION FOR EMPLOYMENT

AN EQUAL OPPORTUNITY EMPLOYER
Pre-Employment screening includes a drug test
Last Name:
First Name:
Middle Initial:
Street Address:
City:
State:
Zip:
Telephone#
Alternate Telephone#
For the safety and health of all Shoreline Container employees, smoking and/or use of tobacco products is strictly prohibited within company buildings, parking lots, hallways, waiting areas, restrooms, break rooms, meeting rooms, offices, work stations, adjacent grounds, personal, company owned and leased vehicles, and all roof areas. To acknowledge notification of this policy enter "accept" below.

EMPLOYMENT INFORMATION

Position(s) Applying For:
Desired Salary:
Preferred Shift:
1st Shift 2nd Shift Open
Date Available for Work:
Will you be required to obtain a work permit (required if under age 18)?
Yes No

EMPLOYMENT HISTORY

Provide the following information of your past employment history, starting with the most recent.
Start Date:
End Date:
Employer:
Phone#
Supervisor:
Job Responsibilites:
May we contact for reference?
Yes No Later
Reason for Leaving:
Ending Pay Rate:
Start Date:
End Date:
Employer:
Phone#
Supervisor:
Job Responsibilites:
May we contact for reference?
Yes No Later
Reason for Leaving:
Ending Pay Rate:
Start Date:
End Date:
Employer:
Phone#
Supervisor:
Job Responsibilites:
May we contact for reference?
Yes No Later
Reason for Leaving:
Ending Pay Rate:

SKILLS / QUALIFICATIONS

Summarize training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying:
Have you been convicted of a felony?
Yes No

If Yes, please explain the circumstances of your conviction, indicating the date, nature, place of the offense and disposition of the case:

EDUCATIONAL BACKGROUND

LevelName and Location (or "none")Did you Graduate?
College Yes No
High School Yes No
Other Yes No

APPLICANT STATEMENT

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to cancel further consideration of this position, or immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, corporations, or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

If I am hired, I understand that I am free to resign at any time, with or without cause and without notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president, or designated representative.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigrations laws require me to complete an I-9 Form in this regard.

By entering "accept" below, I certify that I have read, fully understand and accept the terms of the foregoing Application Statement.