Application Your Personal InformationYour Name First Last Your Email Address Phone NumberAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands How long have you lived at the above address?Position You're Applying ForWhat type of job are you seeking? Full Time Part Time Temporary Any If you were referred to us please list the individual or organization.Position(s) you are applying forDate you can start MM slash DD slash YYYY EducationLevel?Name?Graduated? HighschoolUntitled Yes No College/UniversityUntitledUntitled Yes No N/A Business, Trade, or Military (specify)UntitledUntitled Yes No N/A Skills/ExperienceCheck kinds of work in which you have had Experience Accounting Data Processing Office Practices Building Material Sales Bookkeeping Truck Driving Building Material Purchasing Inside Cashier Forklift Operator Yard Outside Credit & Collections Building Material Mgmt. Warehouse Management None of the above List the Office Skills and/or Plant Shop Machines you are qualified to operate12345678Do You Have Your Valid Driver's License? Yes No Select the highest level of vehicles you are qualified to operate: Passenger Car Light Truck Heavy Truck or Tractor N/A Has your license ever been suspended or revoked?How many convictions for moving violations within past 3 years?If employed, are you willing to take a physical examination at company expense? Yes No Do you agree to take random drug test if employed? Yes No Are you willing to take a pre employment drug screen at our expense? Yes No Have you ever applied to this company before? Yes No Have you ever been employed by DLC? Yes No From? MM slash DD slash YYYY To? MM slash DD slash YYYY Previous EmploymentYour Previous EmployersPlease list your previous employers, the dates you worked and the position you heldEmployer NamePhoneDates FromDates ToReason for Leaving Add Remove As an applicant for employment with this company, I understand the following: Any misrepresentation or falsification of information or significant omissions will be cause for rejection of my application or for subsequent discipline up to and including my dismissal from employment if discovered at a later date. My employment is Not guaranteed for any term, and my employment may be terminated by the company or myself at any time and for any reason. NO management official is authorized to make any oral assurance or promise of continued employment. I authorize and consent to my current and prior employers, educational institutions and persons or organizations named in this application (or accompanying resume) to release any information that may be required to make an employment decision. My employment is contingent upon the results of a drug screening analysis for substance abuse. The results of such analysis may be grounds for disqualifying me or terminating my employment. If I am employed, I agree to comply with and be bound by the safety and health rules and regulations of conduct of the company. May we contact your previous Employers? Yes No Upload Your ResumeAccepted file types: pdf, doc, docx, Max. file size: 25 MB.Are you currently employed? Yes No Where?SignatureDate MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged.
