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Employmentpmgadmin2024-10-02T15:20:49-05:00

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Application for Employment

ALL EMPLOYEES ARE REQUIRED TO PASS A DRUG SCREEN AND POST JOB OFFER EMPLOYMENT PHYSICAL PRIOR TO HIRING. ALL QUALIFIED APPLICANTS WILL RECEIVE EQUAL CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE OR HANDICAP THAT IS UNRELATED TO THEIR ABILITY TO PERFORM FOR THE JOB THEY ARE APPLYING FOR. PLEASE WRITE OR PRINT YOUR ANSWERS IN INK ONLY. IF SUFFICIENT SPACE IS NOT PROVIDED HERE FOR YOU TO GIVE COMPLETE ANSWERS TO CERTAIN QUESTIONS, OR IF YOU WISH TO GIVE PERTINENT INFORMATION NOT REQUIRED, PLEASE ATTACH SUCH ADDITIONAL INFORMATION TO THIS APPLICATION. WE WILL NEED A COPY OF YOUR CURRENT DRIVERS LICENSE.
Date(Required)
Name(Required)
Address(Required)
Email(Required)
Are you 18 years or older?(Required)
This question is asked only for the purpose of Determining whether applicant is of legal age for employment
Are you a citizen of the United States?(Required)
If not, are you legally eligible for Employment in the USA?(Required)
Have you ever been convicted of felonious crime?(Required)
I can perform the essential function of the job in which I am applying for with or without accommodation.(Required)

Education

School Address(Required)
Tobacco User?(Required)
Medicare?(Required)
Medicaid?(Required)

Emergency Contact Information

Name(Required)

Driver Experience & Qualification

Answer the question here ONLY IF APPLYING FOR DRIVER POSITION
Date of birth(Required)
The U.S. Department of Transportation requires that driver applications state their date of birth (section(b)(2))

Licenses

Drivers Licenses held in the past 3 years must be shown
Please list last 3 in following format: 1. STATE / LICENSE NO. / CLASS / ENDORSEMENTS / EXPIRATION DATE
2. STATE / LICENSE NO. / CLASS / ENDORSEMENTS / EXPIRATION DATE
3. STATE / LICENSE NO. / CLASS / ENDORSEMENTS / EXPIRATION DATE
Have you ever been denied a license, permit or privilege to operate a motor vehicle?(Required)
Has any license, permit or privilege ever been suspended or revoked?(Required)

Employment Record

To be considered for employment, information on current & previous employers must be complete; such as phone numbers, addresses, and dates or employment.
Please list all experience you have: Equipment Classes: Straight Truck, Tractor & Semi-Trailer, Twin Trailers - LCV's, Other. | Type of Equipment (Van, Tank, Flat etc) Please include dates of operation and approximate miles driven for each equipment.
Please include; Location, Date(s), Violation/Charge, & Penalty
Have you ever been convicted of driving while under the influence of Alcohol or Drugs?(Required)

Applicants Certification and Agreement

Consent(Required)
I Understand and Agree that:
1.
Drug Screening and Pre-Employment Testing: I Understand and agree that prior to my employment
I must submit to and pass a post job offer physical and Drug Screening test. The company’s doctor or facility will perform these Examinations.
2.
False Statements or Omissions: I hereby certify that the facts and answers to questions set forth in this application for employment are true. I further understand that if employed by the company, any false statement on this application or omission or unanswered question may result in my rejection or dismissal.
3.
Employment at will: I certify and understand that no individual contract of employment exist between
Myself and the company in any form, either in written or verbal. I further understand that if employed, my
Employment exists at the will of the company and myself and has no fixed term or length. I further
Understand that this “At-Will” relationship may not be changed or altered by any person.
3.
No Privacy Right- I understand that I have no expectancy of privacy for any objects, property, and/or
Possessions brought into or onto company property or vehicles. The company has the right to investigate
and search any and all equipment and/or property of the company or personal property brought on the
Company premise’s including the undersigned person and any property I possess on or in the company
Facilities or equipment.
4.
Previous employment verification will be obtained as a part of the Prairie Waste Solutions LLC. evaluation of my job application / pre-employment and employment and required by the Department of Transportation Rules and Regulations. The reports may be procured by Prairie Waste Solutions LLC. and those that they hire to check previous employment or other information deemed necessary for the position applying for.
5.
I agree that any action or suit against Prairie Waste Solutions LLC, or subsidiaries, its agents or employees, arising out of my employment or termination of employment, including, but not limited to, claims arising under State and Federal law, but not Federal civil rights statues containing a separate limitations period, must be brought within 180 days of the event giving rise to the claims or be forever barred unless the applicable statute of limitations periods is shorter than 180 days in which case I will continue to be bound by that shorter limitations period. I waive any limitations periods to the contrary. I further agree that if I should bring any non-statutory action or claim arising out of my employment against Prairie Waste Solutions LLC, in which the firm prevails, I will pay to the firm any and all such costs incurred by the firm in defense of said claims or actions, including attorney fees. I further agree that my employment is conditional until such time as the results of my post-offer physical are known.
6.
By submitting this application to Prairie Waste Solutions LLC. I hereby acknowledge and authorize Prairie Waste Solutions LLC. to obtain previous employment and driving records. I will not hold Prairie Waste Solutions LLC. the persons completing or obtaining the evaluation(s) liable for information released with this authorization. The reports may be procured by Prairie Waste Solutions LLC. and those that they hire to check previous employment or other information deemed necessary for the position applying. I hereby authorize Prairie Waste Solutions LLC. to obtain previous employment records. I will not hold Prairie Waste Solutions, the persons completing or obtaining the evaluation(s) liable for information released with this authorization.
7.
I understand that post job offer employment physical and or DOT physical and Drug Screening cost money and I agree to pay for these if I DO NOT work for Prairie Waste Solutions LLC over 180 Days. I hereby authorize Prairie Waste Solutions to deduct the cost for these pre-employment testing from my final check, or will bill me.
8.
Uniforms: I understand that uniforms are the property of the company, and if I have been supplied with uniforms, I am personally responsible for the replacement cost to replace any and all uniforms that are not returned when I leave employment with the company.
Drug and Alcohol Policy/Consent(Required)
The Company is committed to providing a drug-free work place and expects cooperation of all employees and similar commitment from them. The unlawful manufacture, distribution, possession or use of a controlled substance or alcohol in the work place or outside is prohibited. Any employee who violates the above rule may be subject to corrective action up to and including termination. As a condition of employment, all employees must abide by this rule.

Consent to Perform Medical Tests to determine the Presence of Alcohol, Drugs or Controlled Substances

I understand that remaining free of illegal drugs use is a condition of my employment with the Company. All employees of the Company will be subject to unannounced alcohol and / or drug testing, as a condition of continued employment. I understand that refusal to submit to alcohol and / or drug screening will result in corrective action up to and including immediate discharge. I hereby give consent to the company, through an authorized testing service of its choice, to collect blood, urine, hair or saliva samples, or other fluid or tissues samples from me and conduct any other necessary medical tests to determine the presence of alcohol, drugs or controlled substances, and I hereby release the company from any liability arising out of such test or its results. Further, I give my consent for the release of the test results and other relevant medical information to authorize the company management for appropriate review. I also understand that if I test positive for alcohol and/or illegal drugs I will be responsible for the cost of the test. I understand and agree that such cost will be taken from my paycheck automatically.
Clear Signature
Date(Required)
Name(Required)
Company Staff Witness
ONLINE BILL PAY

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