Nassau Motor Company Employment Application

Employment Application

    Name: (Last, First, Middle)

    P.O. Box:   

    Telephone No.:

    Email:

    Street Address:

    National Insurance No.:

    Date of Birth:

    Age:

    MALEFEMALE

    Height:

    Weight:

    Place of Birth:

    Check One:
    SingleMarriedWidowedSeparatedDivorced

    Number of Dependents:

    Children

    Relatives

    Others

    Spouse’s Name:

    Spouse’s Occupation:

    Position desired:

    Salary requested: $

    In case of emergency, notify:
    Name:

    Address:
    Telephone:

    When are you available:

     

    Do you have a valid driver’s license? YesNo

    Do you own a car? YesNo
    If yes, give:

    Make:   Model:   Year:   Island:   Number:

    Has your driver’s license ever been suspended? YesNo
    If yes, why?

    Have you any physical limitations that would affect your performance on the job? YesNo
    If yes, explain:

    Religion: CatholicAnglicanBaptistMethodistOther

    EDUCATION:
    High School -

    QUALIFICATIONS:

    Technical School -

    College -

    Other -

    RECORD OF PREVIOUS EMPLOYMENT

    Most Recent Employment

    Total length of service

    From Month/Year to Month/Year

      

    Total Time Employed

    Name & address of employer

    Name:
    Address:
    Supervisor:

    Type of work

    Reason for leaving

    Avg weekly earnings

    Previous Employment

    Total length of service

    From Month/Year to Month/Year

      

    Total Time Employed

    Name & address of employer

    Name:
    Address:
    Supervisor:

    Type of work

    Reason for leaving

    Avg weekly earnings

    Previous Employment

    Total length of service

    From Month/Year to Month/Year

      

    Total Time Employed

    Name & address of employer

    Name:
    Address:
    Supervisor:

    Type of work

    Reason for leaving

    Avg weekly earnings

    I UNDERSTAND AND AGREE THAT FOR THE FIRST 12 WEEKS OF EMPLOYMENT I WILL BE ON PROBATION. AT ANY TIME DURING THIS 12 WEEK PERIOD I CAN LEAVE THE EMPLOY OF THE COMPANY OR THE COMPANY CAN DISPENSE WITH MY SERVICES AND NO NOTICE OR PAYMENT IN LIEU OF NOTICE IS REQUIRED BY EITHER SIDE. IF I AM DISMISSED DURING THE 12 WEEK PROBATIONARY PERIOD, I WILL BE ENTITLED TO REMUNERATION ONLY FOR THE ACTUAL PERIOD WORKED.

    Signature of applicant:

    Date:


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