Application For Employment

Personal Information

Position You are Applying For*

Please List Your Current Salary Requirements*

Name*

First Last

Email*

Present Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone*

Are you 18 years or older?*

Yes
No

Are you either a U.S. citizen or an alien authorized to work in the United States?*

Yes
No

Are you currently employed?*

Yes
No

Who referred you to National Waste Associates, LLC?

Resume Upload

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Microsoft Word, PDF and Plain Text formats only.

Educational Information

High School Name

High School Location

High School: Number Of Years Attended

High School: Graduate?

Yes
No

College Name

College Location

College: Number Of Years Attended

College: Graduate?

Yes
No

Trade Or Business School Name

Trade Or Business School Location

Trade Or Business School: Number Of Years Attended

Trade Or Business School: Graduate?

Yes
No

Special Training Or Skills

Work Information

Start with current or most recent employer

Company Name

Current Title

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Work Phone

Starting Date

Leaving Date

Name And Title Of Supervisor

Description Of Work

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Last Salary HIDDEN

Reason For Leaving

Company Name

Position Title

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Work Phone

Starting Date

Leaving Date

Name And Title Of Supervisor

Description Of Work

This field is hidden when viewing the form

Last Salary HIDDEN

Reason For Leaving

Company Name

Position Title

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Work Phone

Starting Date

Leaving Date

Name And Title Of Supervisor

Description Of Work

This field is hidden when viewing the form

Last Salary HIDDEN

Reason For Leaving

Professional References (other than relatives)

Please include at least three references. Use the + button to add additional references.

Name	Relationship to Applicant	Phone	Company	Years Known

Do you have a family member or friend currently active/working in any capacity in the waste and recycling industry?

Yes
No

Please provide the information below.

Name	Relationship	Job Title	Company

Drug And Alcohol Screening

*** I UNDERSTAND THAT IF I AM A QUALIFIED CANDIDATE FOR A JOB OPENING, I WILL BE REQUIRED TO UNDERGO A DRUG AND ALCOLHOL SCREENING WITH A SUBSEQUENT NEGATIVE RESULT AS A CONDITION OF EMPLOYMENT. THE SIGNING OF THIS FORM IS MY PERMISSION FOR NATIONAL WASTE ASSOCIATES, LLC OR IT’S AGENT TO TAKE SAMPLES OF MY URINE AND PERFORM A DRUG SCREENING ON SUCH SAMPLES, AND TO TAKE SAMPLES OF MY BREATH AND PERFORM AN ALCOLHOL SCREENING ON SUCH SAMPLES. FURTHER, I GIVE MY CONSENT FOR THE RELEASE OF THE TEST RESULTS TO AUTHORIZED COMPANY MANAGEMENT FOR APPROPRIATE REVIEW. ***

Signature*

Date*

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 EMPLOYERS LISTED TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE AND RELEASE ALL PARTIES FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING SAME TO YOU. I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINTATED AT ANY TIME WITHOUT ANY PRIOR NOTICE. ***

Signature*

Date*

Application For Employment

Personal Information

Educational Information

Work Information

Drug And Alcohol Screening

Authorization

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