Premier Outdoor Solutions LTD. Application for employment
Pre-employment questionnaire; Equal opportunity Employer  

Personal Information  
Date:
Name:(last name first):   Social Security No.: Date of Birth:
Present Address: City: State: Zip Code:
Permanent Address: City: State: Zip Code:
Phone Number: Driver's License Number: Referred By:  

Employment Desired  
Position Date you can start Salary Desired
Are you employed? If so, may we inquire of your present employer?
 
Ever applied to this company before? Where? When?

Education History
Name & Location of School
Years
Attended
Did you Graduate?
Subjects Studied
Grammar School
High School
College
Trade, Business or Correspondence School
 
General Information  
Subjects or Special study/research work or special training/skills:
U.S. Military or Naval Service Rank:

Former Employers (List below last four employers, starting with last one first)
Date
Month and Year
Name & Address of Employer
Salary
Position
Reason for Leaving
From:
To:
From:
To:
From:
To:
From:
To:

References:
Name
Address
Business
Years Known


Authorization
    "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
    I authorize investigation of all statements contained herein and the references and employers listed above to give you andy and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
   I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
   This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
Date: Signature: (please type in your name for signature)