Omni Cart Services, Inc.
P.O. Box 366 Mentor, Ohio 44061 (800)-525-2278
www.ocserv.com

Application for Employment



Personal Information  

Social Security Number

Drivers License Number
City State Drivers License Issued in What State
Zip Code Phone Number
Email Address Cell Phone Number
   
Employment Desired
 
Location Position
Desired Salary
Where Did You Hear About Our Opening? Are you Currently Employed
May We Contact Your Current Employer?  
   
Name and Location of School  
 
High School Years Attended
Subjects Studied Did You Graduate
   
College Years Attended
Subjects Studied Did You Graduate
   
Trade, Business, Other Years Attended
Subjects Studied Did You Graduate
   
Work or Special Training Skills Languages Spoken
   
U.S, Military Service:  
How long  
Duties  
Rank  
   
Former Employers  
   
Name Phone Number
Address Salary
From To Position
Reason for Leaving Duties
   
   
Name Phone Number
Address Salary
From To Position
Reason for Leaving Duties
   
   
Name Phone Number
Address Salary
From To Position
Reason for Leaving Duties
     
References: Names of three people not related to you  
   
Name Address Phone Number Years Known
   
Name Address Phone Number Years Known
   
Name Address Phone Number Years Known
   
   
Authorization  
   

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

   
By typing your initials in this box you agree to the above statement
Date
   
 

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