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Employment Application
575.393.1525 | 1.800.388.0987 | 4830 Seminole Highway | Hobbs, NM 88240
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>> Employment Application
Come to work for us today. To get started, please download and return the following completed application form or fill out the form online below:
YMH Employment Application
APPLICATION FOR EMPLOYMENT
PRE-EMPLOYMENT QUESTIONNAIRE
EQUAL OPPOTUNITY EMPLOYER
PERSONAL INFORMATION:
Last Name:
First Name:
Social Security Number:
Present Address:
City:
State:
Zip:
Permanent Address:
City:
State:
Zip:
Phone Number:
Referred By:
EMPLOYMENT DESIRED
Position:
Date You Can Start:
Salary Desired:
Are you employed:
Yes
No
If so, may we enquire with your present employer?
Yes
No
Ever applied with us before?
No
Yes
Where?
When?
EDUCATIONAL BACKGROUND
Name and Location of School
Years Attended
Did You Graduate?
Subjects Studied
Grammar School:
Yes
No
High School:
Yes
No
College School:
Yes
No
Trade/Business School:
Yes
No
Subjects of special study/research work, or special training/skills:
US Military Service?
Yes
No
Final Rank
FORMER EMPLOYERS
List below last four employers, starting with the last one first.
Date
(MM/YYYY)
Name and Address
of Employer
Salary
Position
Reason for Leaving
REFERENCES
Give below the names of three persons not related to you, whom you have known at least one year.
Name
Address
Business
Yeas Known
AUTHORIZATION
By submitting this form online you agree to the following:
"I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FLASIFIED 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 ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FORM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.
I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTAVIVE 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."
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