EMPLOYMENT – JLB Logistics INC.

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EMPLOYMENTadmin2019-12-16T03:00:41+00:00

Employment Application

Step 1 of 6

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Date of Interview*
Position Applied For*
How were you referred to us?
Full Name*
Street Address*
City*
State*
Zip*
Phone*
Mobile/Other
Email*
Date Available to Start*
Social Security Number
Salary Requirements*

Have you ever worked for this company?*
- Yes
- No
If yes, when?
Are you a U.S Citizen?*
- Yes
- No
If not, are you legally allowed to work in the United States?
- Yes
- No
Type of Employment Desired*
- Full-Time
- Part-Time
- Temporary
- Seasonal
Have you ever pleaded guilty, no contest, or been convicted of a crime?*
- Yes
- No
If yes, give dates and details.
Driver's License Number, (If applicable to position)
Summarize your special skills or qualifications*

Date of Employment: From*
(Begin with most recent position)
Date of Employment: To*
Positions Held*
Company Name*
Company Address*
Company City*
Company State*
Company Zip Code*
Company Phone*
Supervisor Name*
Supervisor Title*
Responsibilities*
Starting Salary & Title*
Ending Salary & Title*
Reason for Leaving*
May we contact this employer for a reference?*
- Yes
- No

#2 Date of Employment - From:*
#2 Date of Employment - To:*
Positions Held #2*
Company Name #2*
Company Address #2*
Company City #2*
Company State #2*
Company Zip #2*
Company Phone #2*
Company Supervisor #2*
Company Supervisor Title #2*
Responsibilities #2*
Starting Salary & Title #2*
Ending Salary & Title #2*
Reason for Leaving #2*
May we contact this employer for a reference? #2*
- Yes
- No

Date of Employement #3 - From:
Date of Employement #3 - To:
Positions Held #3
Company Name #3
Company Address #3
Company City #3
Company State #3
Company Zip Code #3
Company Phone #3
Supervisor #3
Supervisor Title #3
Responsibilities #3
Starting Salary & Title #3
Ending Salary & Title #3
Reason for leaving #3
May we contact this employer for a reference? #3
- Yes
- No

Signature of Applicant*
In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.
Date*

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Contact Info

431 Lithia Pinecrest Road
Brandon, FL 33511

Phone: (800) 875-2463

Email: Support@JLBLogistics.com

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