Personal Information
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Name *
Phone *
Address *
City, State, Zip *
Email

Position Applying For

Position preferred

Shift preferred

1

2

3

Any

Expected pay

Would you accept full-time work? *		Yes		No
Would you accept part-time work? *		Yes		No

What date would you be able to start?

Have you been employed by Lake City before?

Yes

No

When

Special training or skills:

Languages, certifications, machine operations, etc. that would assist you in the job for which you are applying.

Are you legally eligible for employment in the United States?	Yes		No
If yes, proof is required.

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Employment Experience

Employer 1 *
Address
Phone *

Job Title

Supervisor *

Dates Employed:

From (mm/yy)

To (mm/yy)

Hourly rate/salary

Starting

Final

Work Performed
Reason for Leaving *

Employer 2 *
Address
Phone *

Job Title

Supervisor *

Dates Employed:

From (mm/yy)

To (mm/yy)

Hourly rate/salary

Starting

Final

Work Performed
Reason for Leaving *

Employer 3
Address
Phone

Job Title

Supervisor

Dates Employed:

From (mm/yy)

To (mm/yy)

Hourly rate/salary

Starting

Final

Work Performed
Reason for Leaving

Employer 4
Address
Phone

Job Title

Supervisor

Dates Employed:

From (mm/yy)

To (mm/yy)

Hourly rate/salary

Starting

Final

Work Performed
Reason for Leaving

Educational Background

Grammar School:

Name of school

Location

Course of Study

Did you graduate?

Yes

No

Degree or Diploma

High School:

Name of school

Location

Course of Study

Did you graduate?

Yes

No

Degree or Diploma

College School:

Name of school

Location

Course of Study

Did you graduate?

Yes

No

Degree or Diploma

Graduate School:

Name of school

Location

Course of Study

Did you graduate?

Yes

No

Degree or Diploma

Vocational Training - Other:

Name of school

Location

Course of Study

Did you graduate?

Yes

No

Degree or Diploma

Continuing Education:

Resume

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Disclaimer

	I verify that all of the information I have submitted within this application is true and complete. I understand that if any false of misleading information is found, my application may be rejected, and if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to Lake City's rules and regulations, and I understand that these rules and or the employee handbook do not form a contract of employment either expressed or implied. I agree that my at will employment and compensation can be terminated with or without notice, at any time, at either my or Lake City Truck’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by Lake City Trucks. I understand that no company representative, other than the owner Edward Pace, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

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