Application For Employment Print This Page Email This PageNew England Quality Service, Inc. D.B. A. Earth Waste & Metal 49 Wales Street, Suite 1, Rutland, VT 05701 Provide only information that is requested. The provision of non-responsive information will result in disqualification of this application.Name First Last Present Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Position Desired:Full TimePart TImeSocial Security NumberPlease enter your number per this example: 555-55-5555If you are under 18 years of age can you provide the required proof of your eligibility to work?YesNoHow were you referred?Date able to start: Date Format: MM slash DD slash YYYY Salary desired:Are you able to work all shifts?YesNoIf you answered "no" to the above, when are you UNABLE to work?Are you a U.S. citizen or authorized to work legally in the United States? YesNoCities/States of Residence for the past 7 years: Have you ever been employed here before? YesNoDriving HistoryDo you have a valid driver's license?YesNoDriver's license number:State your driver's license number was issued in:Class of license?Has your driver's license been suspended or revoked in the last 3 years?YesNoIf your license has been suspended or revoked in the last 3 years, please furnish details.How many motor vehicle accidents have you had in the past 5 years? Education and TrainingPlease list all schools you attended from High School to present. Include trade and technical schools and any courses which may be relevant to your application. If more space is needed, please attach additional information to this form.Name of high school attended:Dates attended (from - to)City & StateCourse of Study/DegreeName of trade/technical school attended:Dates attended (from - to)City & StateCourse of Study/DegreeName of college attended:Dates attended (from - to)City & StateCourse of Study/DegreeOther Courses/Schooling (Including apprenticeship):Dates attended (from - to)City & StateCourse of Study/DegreeProfessional or Technical Licenses (for each, list state and date):Please describe any job related skills or training not mentioned above:Work HistoryLIST EMPLOYERS IN ORDER WITH PRESENT EMPLOYER FIRST. ACCOUNT FOR ALL PERIODS OF TIME. IF SELF EMPLOYED, GIVE FIRM NAME AND BUSINESS REFERENCES. WORK PERFORMED ON A VOLUNTEER BASIS MAY BE INCLUDED.1. EmployerAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Start Date Date Format: MM slash DD slash YYYY Leave Date Date Format: MM slash DD slash YYYY PhoneWageJob TitleMay we contact your supervisor?YesNoSupervisor's Name Supervisor's PhoneDescription of Work:Reason for Leaving:2. EmployerAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Start Date Date Format: MM slash DD slash YYYY Leave Date Date Format: MM slash DD slash YYYY PhoneWageJob TitleMay we contact your supervisor?YesNoSupervisor's Name Supervisor's PhoneDescription of Work:3. EmployerAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Start Date Date Format: MM slash DD slash YYYY Leave Date Date Format: MM slash DD slash YYYY PhoneWageJob TitleMay we contact your supervisor?YesNoReason for Leaving:Supervisor's Name Supervisor's PhoneDescription of Work:Reason for Leaving:Have you ever been fired from a job or asked to resign? YesNoIf YES, please explain:Are you on a layoff and subject to recall?YesNo* Are you known to schools/references (prior employers) by another name? YesNo*Information sought solely to facilitate reference checks.If YES, what name?Military ServiceBranchRankDischarge Date Date Format: MM slash DD slash YYYY Training or type of work done in military service:What machines or equipment can you operate that are related to the job for which you are applying? ReferencesProvide names of three persons not related to you, whom you have know at least one year.1. Name Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BusinessPhoneYears Known2. Name Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BusinessPhoneYears Known3. Name Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BusinessPhoneYears KnownRead carefully and sign the statement below:I certify that the information given above is true and complete and understand that misrepresentation and/or omission of requested information will result in the rejection of this application or my discharge if discovered after employment begins. I authorize the company to make inquiries regarding my history and character of prior employers, schools, government agencies or individuals and hereby release such entities and individuals from all liability in responding to inquiries in connection with my application and release the company from all liability with respect to such inquiries.I understand that if employed, I will be an employee “at will” and may be terminated at any time, with or without cause, and with or without notice at the option of either the company or myself. If I am employed, I agree to abide by the companies policies, rules and procedures and any changes thereto. I further understand that no company representative other than the company’s C.E.O., and then only in writing and signed by the C.E.O., has authority to enter into any agreement for employment for any specific period of time or to make agreements contrary to the foregoing.Applicant's SignatureBy entering your name into this field you agree that it constitutes your legal, electronic signature.Date Date Format: MM slash DD slash YYYY We are an Equal Opportunity EmployerIt is the policy of New England Quality Services, Inc. to offer equal employment opportunity to all qualified persons regardless of race, color, religion, national origin, military status, sexual orientation, disability, gender, or age (in accordance with the law) or any other legally protected status.CommentsThis field is for validation purposes and should be left unchanged.