Syracuse Haulers Waste Removal, Inc. is an Equal Opportunity Employer. We consider all applications for all positions without regard to race, religion, creed, color, sex, age, national origin, disability, sexual orientation, gender identity, transgender status, gender dysphoria, marital or family status, pregnancy, military status, veteran status, predisposing genetic characteristics or carrier status, arrest or conviction record, domestic violence victim status, or any other protected class or status. Applicants requiring a reasonable accommodation to participate in the application and/or interviewing process should you notify an organization representative. 

BIOGRAPHICAL DATA

Street Address*
$
Are you Available to Work*
(check all that apply)
Date Available to Begin Work*
Are you 18 years of age or older?*
Are you currently employed?*
If yes, may we contact your employer to obtain employment information?
Have you ever submitted an application and/or interviewed for employment with our organization?*
If yes, give month and year
Have you ever been employed with our organization before?*
From MM/DD/YYY to MM/DD/YYY
Are you legally eligible for employment in the United States?*
Employment eligibility will be verified upon employment.
If you have had an opportunity to review a job description for the position for which you are applying, can you perform the essential functions of this job with or without reasonable accommodation? (check N/A if you have not reviewed a job description)*

Educational Background

Type of School Attended

High School

Name and Location of School*
Did you Graduate?*
Diploma or Degree Obtained*
Did you attend college and/or a trade school?*

Type of School Attended

College

Name and Location of School*

Dates Attended

From*
To*
Did you Graduate?*
Diploma or Degree Obtained*
Did you attend another college and/or trade school?*

Type of School Attended

College

Name and Location of School *
Did you Graduate?*
Diploma or Degree Obtained*

Skills

EMPLOYMENT HISTORY

Provide employment information, including military service, for the last 15 years, starting with the most recent employer first. If you've held more than four jobs, provide this information on another sheet and attach to this Application Form.

Present or Last Employer

If current employer, may we contact?*
$

Next Previous Employer

$

Next Previous Employer

$

Next Previous Employer

$

References

(List three references other than relatives)

Conviction Record Status

All applicants and employees must, as a condition of employment, inform the organization of all convictions. This includes all convictions received within the past seven years, while your application for employment is pending, and within seven days of receiving a conviction if currently employed. 

Have you been convicted of, and/or plead guilty to, a felony or misdemeanor in the past seven years?*

If you answered "yes" and have been convicted of a felony or misdemeanor, please provide additional information below, such as the crime(s), date(s), court location, sentencing information, disposition of sentence, and rehabilitation completed. Please note that a "yes" answer to this question does not necessarily disqualify an applicant for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime as it relates to the job applied for, and rehabilitation will be considered. The organization reserves the right to reject individuals for employment based on job-related convictions. 

Date of Offense*
Rehabilitation Completed*

Please Read Carefully and Sign Below

I hereby certify that all of the information I have provided on this Employment Application is true and correct to the best of my knowledge. I understand that any misrepresentation or omission of the facts will disqualify me from further consideration of employment, withdrawal of any offer of employment, or, termination of employment, if already hired. 

I authorize verification of all of the information I have provided on this Employment Application and understand that additional information may be needed to consider my application of employment. I authorize all previous employers, educational institutions, references, and other persons who have knowledge of me or my records to provide any and all information pertinent to my employment and release the same from any liability resulting from providing such information. I also release this organization and all of it's employees from all liability for any damage that may result from reliance on the information furnished.

*NOTE* Include the following paragraph only if pre-employment medical exams are conducted

After a conditional offer of employment, I understand that a pre-employment medical examination must be passed to the organization's satisfaction before starting.

*NOTE* Include the following paragraph only if pre-employment drug testing is conducted

The organization is committed to providing a drug and alcohol-free workplace. After receiving a conditional offer of employment, I understand that a drug test will be required before starting work. If the results of the test are positive, I understand that the offer of employment will be withdrawn.

I understand that if employed, I am required to abide by all policies, procedures, rules, and regulations of the organization. I also understand and agree that, if hired, my employment is "at-will" and is for no definite period and may, regardless of thew date of payment of my wages or salary, be terminated by myself or the organization at any time with or without cause or notice.

Date*
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