Employment Application

FMC Services, LLC is currently accepting applicants to fill available positions.

To ensure proper consideration, please fill in the information below as completely and accurately as possible.

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Personal Information

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Are you legally authorized to work in the United States? *
Have you ever been convicted of a felony? *
How were you referred to us?
 
Employment type
 
Have you previously applied to or been employed by any of our facilities?
 
Do you have any relatives employed by any of our facilities?
 
Have you ever worked under a different name?
 
Are you willing to relocate?
Do you have adequate means of transportation to get to work on time each day and when called in on short notice during normal working hours?
Are you capable of satisfactorily performing the essential job duties required of the position for which you are applying?

Employment History (list in chronological order)

Current or Last Employer
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May we contact? *
Previous Employer
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May we contact?
Previous Employer
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May we contact?

References (Do not include relatives or previous employers)

Reference 1
 
 
Reference 2
 
 
Reference 3

Education

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Did you graduate?
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Did you graduate?
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Did you graduate?
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Did you graduate?
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Did you graduate?

Acknowledgement

AGREEMENT (Please Read Carefully)

    Your interest in our company is appreciated. We comply with state and federal law regarding equal employment opportunity. Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, citizenship status, age or disability if otherwise qualified with or without reasonable accommodation.

    Applications are kept on file for six (6) months. However, if you have not been hired within three (3) months of the date of your application, you must re-file if you are to be considered for future employment.

    We are an equal employment opportunity employer. Federal law prohibits discrimination in employment practices because of race, color, religion, sex, national origin, citizenship status, age or disability if otherwise qualified with or without reasonable accommodation. No question on this application is asked for the purpose of limiting or excluding any applicant’s consideration for employment because of his or her race, color, religion, sex, national origin, citizenship status age or disability.

    I certify that all of the information given by me on this application, during the interview process or in supplemental form is true and correct to the best of my knowledge and belief. I further understand that false or misleading statements or consequential omissions of any kind on this application or supplemental forms are sufficient cause for my not being hired or my dismissal if I am hired.

    I agree, understand and authorize that this Company or its agents may investigate my background to ascertain any and all information of concern to my record, whether same is of record or not. I authorize the person or organization references on this application to give the Company any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability for any damage that may result from furnishing such information to this Company.

    It is agreed and understood that this application for employment in no way obligates the Company to hire me. If employed, I agree and understand that my employment is for no definite duration, and may be terminated at will by the Company or me. It is agreed and understood by me that participation in any of the benefit programs of the Company does not create a contract of employment for a definite period of time. Additionally, the Employment Handbook or other statements of Company policy is not a contract and can not create a contract of employment for a definite period of time. I agree and understand that only the President, Executive Vice President, or Senior Vice Presidents have the authority to establish a contract of employment with me, and that any such contract must be in writing, designated as an employment contract, and signed by both parties.

    In the event of my employment, any Company materials entrusted to me during the course of my employment will be returned to the Company on the last day of my employment, whether I resign or am terminated. I agree and understand, that should I be employed, I will not at any time or in any manner, either directly or indirectly, divulge, disclose or communicate to any person, firm or corporation any matters affecting or relating to the business of the Employer, including without limiting the generality of the foregoing, its services, its manner of operation, its plans, and any other “proprietary information.” I understand that I will be required to sign a confidentiality/conflict of interest statement consistent with this paragraph as a condition of employment.

    I agree and understand that should the Company loan me any money or property during the course of my employment and that said loan is not paid off or property is not returned prior to the termination of my employment with the Company, the Company may deduct money from my final pay to the extent allowed by law, and I will remain responsible for paying off the remainder of said amount immediately.  I further agree that, according to Company policy, paid time off may be used in excess of that which has been accrued; but that if, at time of termination of employment, my paid time off balance is in a deficit amount, that amount will be withheld from my final paycheck.

    I agree and understand that if I am employed, I must abide by all the existing Company policies, rules, and procedures established by the Company from time to time, which includes but is not limited to substance testing.

    This certifies that this application was completed by me, and that all entrees on it and information in it are true and complete, to the best of my knowledge. I further understand that misrepresentations as to pre-existing physical or mental condition may void my workers’ compensation benefits.

Electronic Signature *
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