Employment Application

How did you hear about us?
Have you ever been registered with us before or applied with us before? NoYes
When:

Please leave this field empty.

Name:
Date:
Address:
City:
Zip:
Phone:
Cell:
E-mail address:
Have you ever been arrested?: NoYes
If yes, please give date and explain the nature of the arrest:
Do you have a clean driving record?: YesNo
If No, please explain:
What days & hours are you available for work?
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
The demographic information contained in this registration form will be submitted for background screening.

Date of Birth:
Hair Color:
Place of Birth:
Height:
Sex: MaleFemale
Weight:
Race:
Country:
Eye Color:
Valid Driver’s License: YesNo
License No:
SS#:
Name of HighSchool
State:
GED or Diploma GEDDiploma
List 3 Personal references- Do Not List Co-Workers or Relatives

Start with most current place of employment
I, hereby authorize All Generations Transport Services to request & receive from all prior employers within one year of the date of this application, and & all pertinent information concerning my prior employment & its termination including the reason for such termination. I hereby state that all the foregoing information I have supplied is a true & complete statement of the facts. False statements contained in this application an immediate cause for dismissal. I further give permission for All Generations to verify all schooling & references and to perform all necessary background screening tests pursuant to Federal and State laws and policies and procedures. In compliance with Fair Credit Reporting Act & the Consumer Credit Reporting Reform Act, and the applicable laws of Florida, this notice is to inform you that consumer reports including credit bureau reports, motor vehicle reports, criminal reports, drug tests, consumer investigations, and medical information may be obtained in connection with our registration. If obtained, this consumer report may be used in making decisions concerning your registration status with this company. I understand and it has been fully disclosed to me that I am an Independent contractor with All Generations Transport Services, Therefor, I am not entitled to benefits such as workers compensation coverage or unemployment compensation coverage. I also understand that All Generations Transport Services will not be responsible for deducting any taxes, Federal, State or local, from my pay advance on or on behalf of All Generations Transport Services. I will be issued a 1099 form at the end of the year.
Signature of Registrant: