Environmental Management Employment Application
Environmental Management Employment Application
Environmental Management Employment Application
Environmental Management
Post Office Box 700
Guthrie, Oklahoma 73044
405-282-8510
Name:______________________________________________________ ______-____-________
(Last) (First) (Middle) Social Security #
_____________________________________________________________ ___________________
City/State/Zip Telephone #
Number of years you have been a resident at this address? __________ (If less than 3 years, please list previous address.)
_____________________________________________________________ ___________________
City/State/Zip Telephone #
Available for: ___ Full-time or ___ Part-time Employment Date you will be available _____________________
Have you ever been arrested for anything other than a speeding ticket? Yes No
If “Yes”, please give a brief description of the incident(s) including dates: _________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Do you understand that most positions at Environmental Management require a Class A Commercial
Driver’s License with a Hazardous Materials Endorsement? Yes No
Do you understand that all positions at Environmental Management require a background security check
and your employment depends on successful clearance? Yes No
Do you understand that Environmental Management maintains a drug-free workforce and you will be
subject to pre-employment, random, and reasonable suspicion drug and alcohol testing? Yes No
Do you understand that you could be subject to “call back” to work after hours? Yes No
Acceptance of a position with Environmental Management means you agree to the above mentioned requirements.
Section II. Military Service
Have you ever served in the United States Military? Yes No (If “No” skip to Section III)
If “Yes” which branch of the service? _____________________________ Are you still Active? Yes No
College
Technical/Vocational
Other
_____________________________________________________________________________________________
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Employer: _______________________________________________________ Phone:______________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Section V. References
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Section VI. Applicant Statement
I certify that all information I have provided in order to apply for and secure work with Environmental Management
is true, complete and correct.
I expressly authorize, without reservation, Environmental Management, its representatives, employees or agents to
contact and obtain information from all references (personal and professional), employees, public agencies,
licensing authorities and educational institutions, and to otherwise verify the accuracy of all information provided by
me in this application, résumé or job interview. I hereby waive any and all rights and claims that I have regarding
Environmental Management, its agents, employees or representatives, for seeking, gathering and using such
information in the employment process and all other persons, corporations or organizations for furnishing such
information about me.
I understand that Environmental Management does not unlawfully discriminate in employment and no question on
this application is used for the purpose of limiting or excusing any applicant from consideration for employment on
a basis prohibited by applicable local, state or federal law.
I understand that this application remains current for 120 days. At the conclusion of that time, if I have not heard
from Environmental Management and still wish to be considered for employment, it will be necessary to reapply
and fill out a new application.
I understand that I may be required to submit to a pre-employment physical examination to determine my physical
ability to perform my job, and that my employment will be contingent upon the results of the examination, including
a drug screening analysis for substance abuse.
If applicable, I understand that my employment or termination will be contingent upon having and maintaining a
Class A Commercial Driver’s License with a Hazardous Materials Endorsement and receiving successful clearance
from a background security check.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and
Environmental Management reserves the same right to terminate my employment at any time, with or without cause
and without prior notice, except as may be required by law. This application does not constitute an agreement or
contract for employment for any specified period or definite duration. I understand that no supervisor or
representative of the employer is authorized to make any assurances to the contrary and that no implied oral or
written agreements contrary to the foregoing express language are valid unless they are in writing and signed by
Environmental Management’s president.
I also understand that if I am employed by Environmental Management I may be required to take training courses in
accordance with 29 CFR 1910.200, if I can not provide evidence of prior successful completion. The cost of this
training is valued at $650.00. If, during the first six months of my employment, I resign or am terminated, I may be
required to reimburse the company the total cost of the training. Said reimbursement may be deducted from any
monies due me by Environmental Management.
I understand that any information provided by me that is found to be false, incomplete or misrepresented in any
respect, will be sufficient cause to (1) cancel further consideration of this application, or (2) immediately discharge
me from Environmental Management’s services, whenever it is discovered.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
Please submit a copy of your current Driver’s License along with this application.
6/24/05