Employment Opportunities

PROSOCO Employment Application

We Are An Equal Opportunity Employer.
All employment offers are contingent upon passing a drug test.

If you would like to submit your résumé with this application, you will be given the option to do so after completing this application.

Fill out all questions as completely as possible. If I question does not pertain to you, please respond with 'NA'.

Today's Date: 10/23/2017


Personal Information
     
Full Name  
(First) (Middle) (Last)
     
E-mail Address  
     
Street Address    
Street  
City  
State  
Zip  
     
Telephone Number    
Home    Ex: 913-555-5555
Other  
     
Have you ever Applied at PROSOCO before?   Yes       No
If yes, when?    Ex: 01/18/2000
     
Were you referred by a PROSOCO employee?   Yes       No
     
If yes, who?  
     
If no, how were you referred to PROSOCO?  
     
Type of Employment Desired   Full-time
Part-time
Temporary
     
If part-time or temporary, what hours/dates work best for you?  
     
What department are you interested in working?  
     
For what position are you submitting this application?  
     
If you selected 'Other Position', specify the position  
     
Desired starting pay   Per hour      Per year
     
When could you begin work?    Ex: 01/18/2000
     
Are you 18 years of age or older ?   Yes       No
     

Education
College, university, business
or trade school that you have attended
Did you graduate?
Field of Study
 
Name
Yes
Location
No
 
 
Name
Yes
Location
No

 

Skills and Experience

Please list any special training, education or skills that you feel warrant consideration by the company.


Work Experience
 
Present or last employer:
   
Name
Address
Phone Number
Dates of employment (Month/Year)
From To
Starting Pay Ending Pay
Position
Supervisor
   
Explain reason / circumstance for job change

 
Would you expect this employer to say they would rehire you for the position you last held there? Yes      No
   
May inquiries be made of this employer ? Yes      No
 
 
Employer prior to the one listed above:
   
Name
Address
Phone Number
Dates of employment (Month/Year)
From To
Starting Pay Ending Pay
Position
Supervisor
   
Explain reason / circumstance for job change
   
Would you expect this employer to say they would rehire you for the position you last held there? Yes       No
   
May inquiries be made of this employer? Yes       No
 
 
Employer prior to the one listed above:
   
Name
Address
Phone Number
Dates of employment (Month/Year)
From To
Starting Pay Ending Pay
Position
Supervisor
   
Explain reason / circumstance for job change
   
Would you expect this employer to say they would rehire you for the position you last held there? Yes       No
   
May inquiries be made of this employer? Yes       No
   

Legal
     
Have you been convicted of a felony within the last five years?
  Yes       No
     
If yes, please list date of conviction and explain:  
Conviction of a crime does not necessarily disqualify you from consideration for employment but may be relevant if job-related.
     
Do you know of any reason why you could not perform the position for which you are applying with or without accommodations?   Yes       No
     


Authorization

I certify that I have read and understand all parts of this application and certify that I have truthfully and completely answered all questions. I understand that falsification of any of the information given herein or on any other employment form is grounds for immediate termination, regardless of when such falsifications may be discovered.

I authorize PROSOCO and its representatives to investigate my education, employment experience, criminal conviction records, and all other aspects of my background relevant to my proposed employment, including all statements made by me in my application for employment. I release PROSOCO and its representatives, as well as any person to whom such inquiry is directed, from any liability arising directly or indirectly from any such investigators.

Further, I understand that employment will be contingent upon successfully passing a pre-employment drug-screening test.

I understand my employment with PROSOCO is for no definite length of time. I understand my employment may be terminated at any time with or without cause, at the option of PROSOCO or myself. I understand that no employee or representative of PROSOCO has any authority to make any agreement which is contrary to the foregoing. If accepted for employment, I agree to enter into and sign a Non-Disclosure or Non-Compete (dependent upon the position) as a condition of my employment. I agree to comply with all company policies and procedures and with all rules and regulations made known at the time of employment or any other time thereafter, and to perform all duties assigned to me to the best of my ability. I agree that the laws of the State of Kansas shall control any interpretation of my rights as an employee of PROSOCO.

I agree       I do not agree

Enter today's date
Ex: 10/23/2017

Digitally sign by entering your full name


Disclosure and Release

In connection with my application for employment with PROSOCO, I understand that consumer reports which may contain public record information may be requested. These reports may include the following types of information: names and dates of employment; reason for termination of employment, accidents, work experience, etc. I further understand that such reports may contain public record information concerning my driving record, credit, bankruptcy proceedings, criminal records, etc., from federal, state and other agencies which maintain such records.

You have the right, upon written request, to receive a written description of the nature and scope of the investigation requested and a written summary of your rights under the Fair Credit Reporting Act.

I authorize, without reservation, any person or entity contacted by PROSOCO or its agent or agents to furnish the above-stated information, and I release any such person or entity from any liability for furnishing such information.

I agree       I do not agree

Enter today's date
Ex: 10/23/2017

Dgitally sign by entering your full name