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Human Resources Manager Application

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Personal Information

 
 
 
 

Are you 18 years or older?*

 

Are you prevented from lawfully becoming employed in this country because of visa or immigration status?*

 

Have you failed or refused a DOT drug or alcohol pre-employment test within the past two years from an employer that did not hire you?*

 
 

Employment Desired

 
 
 
 
 

Education

High School

 
 

College

 
 

Further Education

 
 

Other

 
 
 

Employment History

Are you employed now?*

Do we have permission to contact your previous employers?*

 
 

Employer #1

List Last Three Employers Starting with Most Recent.

 
 
 
 

Employer #2

 
 
 
 

Employer #3

 
 
 
 
 
 
 
 

References

Give the names of three persons not related to you, whom you have known at least one year.

 

Reference #1

 
 

Reference #2

 
 

Reference #3

 
 

Upload Resume

Please attach your resume if you would like it to be submitted with your application for this job vacancy. (Not Required for submission of application.)

 
 
 
 

Emergency Contact

 
 

Invitation to Identify for Affirmative Action Purposes

Exline, Inc. is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, sex, national origin, age, disability, or any other basis prohibited by federal, state, or local law. No question on this form is intended to secure information to be used for such discrimination. Exline, Inc. is required by federal regulations to report information as requested below. Your contribution of this information is completely voluntary. The information you provide is strictly confidential.

Please Select One:

 
 

Indicate the Appropriate Race/Ethnic Group:

 
 
 
 
 
 
 
 

Veteran Status:

 
 
 
 

Other Protected Veteran means veterans who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign for which a campaign badge has been authorized. The information is available at http://www.opm.gov/veterans/html/vgmedal2.asp.

 
 

"I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employer and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative other than it’s President, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."

I understand that entering my full legal name in the box below is the electronic equivalent of a signature.

 
 

This form has been revised to comply with the provisions of the American with Disabilities Act and the final regulations and interpretive guidance promulgated by the EEOC on January 21, 2011.

 

We follow the Law!
This company hires lawful workers only - U.S. citizens or nationals and non-citizens with valid work authorization — without discrimination. Federal immigration law requires all employers to verify both the identity and employment eligibility of all persons hired to work in the United States. In its efforts to meet the law’s requirements, this company is participating in the Basic Pilot program established by the Department of Homeland Security and the Social Security Administration (SSA) to aid employers in verifying the employment eligibility of all newly-hired employees. Our participation in the pilot program does not exempt us from the obligation to complete a Form I-9 for everyone we hire

For additional information on the verification program contact the:
Department of Homeland Security
USCIS/SAVE Program
111 Massachusetts Avenue, 2nd floor
Washington, DC 20001
Phone (888) 464-4218

 

Exline, Inc. is an equal opportunity/affirmative action employer.

 

In compliance with U.S. Citizenship and Immigration Services, Exline, Inc. runs all applications through E-Verify upon submission. Also, please be aware that all racial information voluntarily provided is submitted to the the U.S. Equal Opportunity Commission.

 
 

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Image of Rick Spurlock

Rick Spurlock

Manager of North & Mid-Atlantic Regions

Office: (800) 255-0111

Fax: (785) 826-4425

Cell: (785) 452-1207

r.spurlock@exline-inc.com

Image of Rick Spurlock

Rick Spurlock

Manager of North & Mid-Atlantic Regions

Office: (800) 255-0111

Fax: (785) 826-4425

Cell: (785) 452-1207

r.spurlock@exline-inc.com

Image of Rick Spurlock

Rick Spurlock

Manager of North & Mid-Atlantic Regions

Office: (800) 255-0111

Fax: (785) 826-4425

Cell: (785) 452-1207

r.spurlock@exline-inc.com

Image of Rick Spurlock

Rick Spurlock

Manager of North & Mid-Atlantic Regions

Office: (800) 255-0111

Fax: (785) 826-4425

Cell: (785) 452-1207

r.spurlock@exline-inc.com

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