Job Information

Type of Employment Seeking (required)

Date available to start work (required)

Personal Information

Are you 18 years of age or older?

If hired, can you furnish proof you are eligible to work in the U.S.?

Have you ever applied here before?

If Yes, When?

Were you ever employed here?

If Yes, When?

Are you now or do you expect to be engaged in any other business or employment?

If Yes, What?

How many days of work have you missed during the past year? (Exclude absences due to disability or those covered by the Family and Medical Leave Act)

Number of days?

Have you ever been convicted of a crime?

If yes, provide details. (A yes answer does not automatically disqualify you from employment; nature of offense, date of occurrence, and job applied for are also considered)

Education Applicable to Role (most recent first)

School 1

School 2

School 3

School 4

School 5

School 6

Skills

What skills or additional training do you have that are related to the job for which you are applying?

What machines or equipment can you operate that are related to the job for which you are applying?

For Driving Jobs ONLY: Do you have a valid driver’s license?

Have you had your driver’s license suspended or revoked in the past three years?

If yes, please explain:

List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships that reveal race, color, religion, national origin, sex, age, disability or other protected status.)

Work History

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and business references. Note: A job offer may be contingent upon acceptable references from current and former employers.

Employment Period

Pay

Reason For Leaving

Title/Duties

Employment Period

Pay

Reason For Leaving

Title/Duties

Employment Period

Pay

Reason For Leaving

Title/Duties

Employment Period

Pay

Reason For Leaving

Title/Duties

References

Have you worked or attended school under any other names?

If yes, give names:

Are you presently employed?

If yes, whom do you suggest we contact? (Name/Phone):

Have you ever been fired from a job or asked to resign?

If yes, explain:

Please provide three references as follows: 1. current or past direct supervisor, 2. current or past coworker 3. reference of your choice (excluding relatives). Please Include the email address for each reference:

How did you hear about us?

If other, please describe

Applicant Statement

Please read each statement carefully before signing.

I certify that the facts and information provided in this employment application are true and complete. I understand that any falsification, misrepresentation, or omission in this application (or on any required documents) will be cause for my denial of employment or termination of employment, regardless of when or how discovered.

I authorize the investigation of any or all statements contained in this application. I authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release from all liability any persons, employers, or organizations supplying such information during the investigation. I also release OAM + i’move from all liability which may result from making the investigation.

I understand that in connection with my relationship with OAM + i’move, a background check also known as a consumer report may be procured about me for employment, internship, or externship purposes. The report may include my background information from a law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company. Background checks are requested by the following agency: Michigan State Police Internet Criminal History Access Tool (ICHAT); P.O. Box 30634, Lansing, Michigan 48909; Telephone 517-241-0606; https://apps.michigan.gov/

I understand that any employment offer is contingent upon my providing, within three (2) working days of employment, valid proof of identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986. I agree, if I am offered and accept a position, to follow all existing and future OAM + i’move policies and procedures. I understand that, if employed, my employment will be at-will, meaning that either party can end the employment relationship at any time and for any or no reason.

I have read and reviewed the information provided in this application and the above statements. By signing this application, I certify that I understand all parts and have answered all questions completely.

Enter your name to electronically sign:

Date: