7/30/2019 ECPhillips Job Application
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To Complete Please Print
PERSONAL INFORMATIONLast Name First Name Middle Name Social
Security Number
Present Address (Street, City, State and Zip Code) Telephone
Number
( )
Permanent and/or Mailing Address (if different than above)
Permanent Telephone No.
( )
Will visa or immigration status prevent lawful employment? Yes
No
If you are under 18 years of age, can you provide required proof
of your eligibility to work? Yes No
During the last seven (7) years, have you been convicted of
Nature of Offenseany criminal offense involving violent behavior,
dishonesty,
or breach of trust? Yes No If yes, state the nature of
the offense, date and disposition.*PLEASENOTE:
ACONVICTIONRECORDWILLNOTNECESSARILYBARYOUFROMEMPLOYMENT.
Date/Disposition
EMPLOYMENT DESIREDPosition/Job Date Available
From: To:
Who referred you to this company?
Given your knowledge, skills, education and experience, are you
able to perform all of the essential functions of the position for
which
you are applying, with or without reasonable accommodations as
set forth in the job description? Yes No If no, please explain
fully.
OCCUPATIONAL SKILL/EXPERIENCEList any additional experience,
skills or training applicable to the position for which you are
applying:
EDUCATIONAL BACKGROUND
HIGH SCHOOL COLLEGE TRADE OR TECH SCHOOLS
Name of School:
Location of School:
Did you Graduate? No Yes Date:___________
Degree/Studies:_____________
No Yes Date:___________
Degree/Studies:_____________
No Yes Date:___________
Degree/Studies:_____________
REFERENCESGive below the names of two persons not related to
you, whom you have known at least one year. NATURE OF
NAME ADDRESS AND TELEPHONE RELATIONSHIP
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E.C. PHILLIPS & SON, INC.Producers and Processors of Quality
Alaska Seafood
P.O. Box 7095
Ketchikan, Alaska 99901
Phone 907-247-7975 Fax 907-225-7250
Application for Employment
This company is an equal opportunity employer and
does not unlawfully discriminate on the basis of
race, sex, age, color, religion, national origin,
marital status, veteran status, disability status, or
any other basis prohibited by federal, state or local
law. Please let us know if you need
accommodations in order to participate in the
application process.
7/30/2019 ECPhillips Job Application
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E.C. PHILLIPS & SON, INC APPLICATION FOR EMPLOYMENT
WORK HISTORY LIST MOST RECENT EMPLOYER FIRST. Include at least
past five (5) years, and account for any time gaps in your
employment history. Attach additional sheet if necessary.
Employer Telephone Number
( )Position(s) Held and Description of Duties
Address Salary / Hourly RateStart End
City and State Date Hired
Mo___________/Yr____________
Name & Title of Supervisor Date Separated
Mo___________/Yr____________
Reason for Leaving
Employer Telephone Number
( )Position(s) Held and Description of Duties
Address Salary / Hourly RateStart End
City and State Date Hired
Mo___________/Yr____________
Name & Title of Supervisor Date Separated
Mo___________/Yr____________
Reason for Leaving
Employer Telephone Number
( )Position(s) Held and Description of Duties
Address Salary / Hourly RateStart End
City and State Date Hired
Mo___________/Yr____________
Name & Title of Supervisor Date Separated
Mo___________/Yr____________
Reason for Leaving
IN CASE OF EMERGENCY NOTIFY:
Name: Phone: ( ) Relationship:
READ CAREFULLY BEFORE SIGNING(1)
(2)
(3)
(4)
(5)
I certify that all the information I have provided in
thisapplication is true and complete, to the best of my
knowledge. I understand that, if employed, falsifiedstatements
on this application or failure to furnish allrequested information
may result in my dismissal.
I authorize my former employers, schools, and personalreferences
to provide any information they may haveregarding me. I hereby
release those persons or entitiesfrom all liability for providing
such information.
I understand that, if employed, I can be terminated at any
time with or without cause and with or without notice.
I agree to comply with all work rules of the company.
Prior to employment I must provide information
showingeligibility for employment in the United States and
identification.
(6)
(7)
If employed, I agree that if E.C. Phillips & Son,
Inc.advances or loans any money during the course of my
employment, or if I lose, damage, or fail to return anycompany
property, the company is authorized to deductfrom my wages
sufficient funds to repay such loans oradvances or to replace its
property.
E.C. Phillips & Son, Inc. has a SUBSTANCE ABUSEPOLICY
strictly prohibiting the use, sale or illegal
possession of a controlled substance or drug not medically
authorized. Any offer of employment is contingent
uponverification by drug screening test that applicant is free
from the presence of non-authorized drugs.
I have read and understand these seven statements.
_________________________________________________
________________________
APPLICANTS SIGNATURE DATE
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