Employment Application (old)

Applicant Information




References - Please list three Professional References


Previous Employment


Military Service


Applicant Acknowledgement and Authorization - Please read carefully before checking the box

  • I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery. I understand that submission of an application does not guarantee employment. I further understand that, should an offer of employment be extended by Safe-Grain/Maxi-Tronic that such employment with Safe- Grain/Maxi-Tronic is at will, for no specified duration and may be terminated by either Safe-Grain/Maxi- Tronic or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of Safe-Grain/Maxi-Tronic or its representatives used during the employment process is deemed a contract of employment real or implied. I understand that no representative of Safe-Grain/Maxi-Tronic except the President has the authority to enter into any agreement guaranteeing any conditions of employment or any agreement contrary to the foregoing statements and that any such agreements must be made in writing and signed by the President of Safe-Grain/Maxi-Tronic. In consideration for employment with Safe-Grain/Maxi-Tronic, if employed, I agree to conform to the rules, regulations, policies and procedures of Safe-Grain/Maxi-Tronic at all times and understand that such obedience is a condition of employment. I understand that due to the nature of Safe-Grain/Maxi-Tronic business, attendance and punctuality are considered essential requirements of every job at Safe-Grain/Maxi- Tronic and that poor attendance or tardiness will result in disciplinary action. I understand that if offered a position with Safe-Grain/Maxi-Tronic, I may be required to submit to a pre- employment medical examination, drug screening and background check as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employments tests and checks will result in withdrawal of any employment offer or termination of employment if already employed. I understand that due to the nature of the business Safe-Grain/Maxi-Tronic requires a well-groomed appearance and the covering of body art/wording, or covering/removing body and facial piercings when in view of customers. I understand that due to safe manufacturing practices, Safe-Grain/Maxi-Tronic prohibits the wearing of items that can potentially cause a hazardous situation for the employee or others, including chains, excessively long necklaces and hair longer than shoulder length, which if longer than shoulder length must be tied back for safety. I herby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to Safe-Grain/Maxi-Tronic and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information. BY CHECKING "YES" BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS.

  • The purpose of this notice is to inform you that we will be conducting a pre-employment background investigation in conjunction with your application for employment with our company. This background investigation may involve verifying or reviewing any of the following relevant information: o Social Security Number o DVM Record o Criminal Convictions o Prior Employment History o Educational History As part of this investigation, Safe-Grain/Maxi-Tronic will obtain a consumer report from a Consumer Reporting Agency, (insert name of Agency), for employment purposes. A copy of the report will be provided to you, free of charge, if you wish. By your signature below, you authorize Safe-Grain/Maxi-Tronic to obtain this consumer report. If you wish to receive a copy of the report, please include your address below. This notice and authorization is in accordance with the Fair Credit Reporting Act. I authorize Safe-Grain/Maxi-Tronic to obtain a consumer report for employment purposes
  • Drug and Alcohol Test Consent

  • I hereby CONSENT to allow [Medical Facility] to take a specimen of my hair, urine, or blood and submit it for a pre-employment, random, or reasonable suspicion drug test screen. I FURTHER CONSENT to allow the laboratory testing service to make the results of such screen available to the prospective or current employer Safe-Grain/Maxi-Tronic. In consideration for such services being rendered on my behalf, I hereby RELEASE the laboratory testing service, its officers, agents, and employees, from any and all claims which I might otherwise have due to such results being made so available. I hereby CONSENT NOT TO FILE ANY ACTION at law or in equity against Safe-Grain/Maxi-Tronic, the laboratory testing service, their respective officers, agents or employees in connection with the results of such screen being made so available, and I hereby agree to INDEMNIFY and SAVE HARMLESS Safe-Grain/Maxi-Tronic, the laboratory testing service, their respective officers, agents, and employees from all damages, expenses, reasonable attorney's fees, and costs of court which they or any of them may suffer or incur, jointly or severally, due to the results of such screen being made so available.