HRIS Manager

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Employment Application

Position: HRIS Manager

Please read carefully and answer each question fully.

Personal Information

Last Name*First Name*MI*

Present Address

Address*Address 2
City*State*Zip Code*
Email AddressPhone Number*Years at this Address
How did you learn of this opening?*
Have you worked for us before? If yes, when?
If hired, on what date will you be able to start work?
Are you 18 years of age?*
Are you physically able to perform the job in question?*

Are there any other skills or qualifications which you feel would especially fit you for work with the Company?

Have you ever been convicted of a felony?* If yes, when?*
Have you ever been convicted of a serious misdemeanor?* If yes, when?*
If yes, describe in full.

Educational Background

Name and Address Years Completed* Course or Major*
High School*
College
Post Graduate
Business or Trade
Other

Military Service Record

Have you ever served in the armed forces?* If yes, what branch?
FromToRank at Discharge

Personal References List up to three, excluding former employers and relatives.

Name and OccupationAddressPhone
1.
2.
3.

Prior Employment List in order, most recent employer first.

Dates Name and Address of Employer Rate of Pay Supervisor Name and Title
From*To*StartFinish
Reason for Leaving
Describe in detail the work you did.

Add Another Employer

May we contact the employers listed above?
If not, indicate below which one(s) you do not wish us to contact.

Dexter Laundry, Inc. is committed to a workplace free of unlawful discrimination and harassment. Dexter Laundry, Inc. recognizes that it is unlawful to discriminate in hiring or in any other term of employment on any of the following basis: race, sex, color, religion, national origin, age, disability, sexual orientation, gender identity, military status, or genetic information. Equal Opportunity Employer.

Certification (Read Carefully)

I certify upon my honor that the foregoing statements are made truthfully and without evasion, and further agree that such statements may be investigated and if found to be false will constitute sufficient reason for my dismissal, and do rather agree, if hired, to abide by the rules and policies of Dexter Laundry, Inc. I agree to fill out any further forms necessary to complete or supplement this application. Dexter Laundry, Inc. requires a background screen and a drug test as part of a pre-employment physical.

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