Bekins, Inc. (herein after referred to as “Company” or “Employer”) is an Equal Opportunity Employer. It is our policy to afford equal employment opportunity regardless of race, religion, color, national origin, sex, age, marital status, height, weight, genetic information, disability or any other legally protected characteristic. The law requires that a person with a disability or handicap requiring accommodation for employment must notify the employer in writing within 182 days after the need is known.
 

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Type of Employment Desired * Full Time
Part Time
Temporary Seasonal
How did you hear about us *
Salary desired *
First Name *
Middle Name
Last Name *
Address *
City *
State *
Zip Code *
E-mail Address *
Telephone Number *
 
If you are employed now, may we contact you at work? Yes
No
Work Number
Are you at least 18 years of age? * Yes
No
How many years have you lived in the community? *
Have you ever filed an application here before? * Yes
No
Are you legally eligible for employment in this country? * Yes
No
 
Date available for work: *
Are you on lay-off and subject to recall? * Yes
No
Do you have a valid Michigan drivers license? * Yes
No
Do you have any points on your driving record? * Yes
No
If yes, how many?
What equipment can you operate specific to this job?
Will you travel if the job requires it? * Yes
No
Are you able to meet the attendance required of this position? * Yes
No
Will you work overtime if required? * Yes
No
Have you ever had any criminal conviction, with pending felonies, or a felony? * Yes
No
If yes, please explain giving details including dates, circumstances and nature of crime. (Such conviction may not necessarily bar you from employment.)
Do you have any pending felony arrests? * Yes
No
If yes, please explain.
Have you ever been fired or asked to resign in lieu of discharge? * Yes
No
If yes, please explain.
Summarize any special training, skills, licenses, other languages, certificates and/or characteristics of yourself or assignments or volunteer activities that may qualify you as being able to perform job-related functions for the position which you are applying. *
 

Employment History

Employer *
Address
Telephone
Dates Employed From *
To *
Job Title *
Immediate Supervisor & Title *
Hourly Rate/Salary – Starting *
Hourly Rate/Salary – Ending *
May we contact this employer? * Yes
No
Work performed *
Reason for leaving *
 
Employer *
Address
Telephone
Dates Employed From *
To *
Job Title *
Immediate Supervisor & Title *
Hourly Rate/Salary – Starting *
Hourly Rate/Salary – Ending *
May we contact this employer? * Yes
No
Work performed *
Reason for leaving *
 
Employer *
Address
Telephone
Dates Employed From *
To *
Job Title *
Immediate Supervisor & Title *
Hourly Rate/Salary – Starting *
Hourly Rate/Salary – Ending *
May we contact this employer? * Yes
No
Work performed *
Reason for leaving *
 

Education

High School *
College
Trade, Business or Correspondence School
U.S. Military or Naval Service
Rank
Present membership in National Guard or Reserve
 

References

Name
Telephone
Years Known
Name
Telephone
Years Known
Name
Telephone
Years Known
 

List professional trade, business or civic associations and any offices held

Organization
Office(s) held
Organization
Office(s) held
Organization
Office(s) held
 
I have read and understand Bekins Conditions of Employment. See below to view. * Yes
Date
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