PRE-EMPLOYMENT QUESTIONNAIRE

Personal Information


Desired Employment

Who referred you to this company? (Circle one)


Education

School Level Name & Location of School # of years attended Did you Graduate?
Grammar School
High School
College
Trade, or Correspondence School


Employment History


References

Below, give the names of three persons you are not related to, and known at least one year.


Service Record (Optional)


Have you been convicted of a felony within the last 5 years?

If yes, explain (will not necessarily exclude you from consideration).


Referral


Please Read Carefully Before Signing

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. I 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.

If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time, with or without cause and with or without notice."

I have read and understand by my signature consent to these conditions.

Signature

Date

Feel Free to Drop Us A Line

  • 1321 South Earl Drive #A
    Salt Lake City, Utah 84104

  • info@doubledei.com

  • (801) 972-5027
    (801) 972-1355