Day Company Employment Application
Complete this form in order to apply for an open position with Day Company.  Please understand that we will respond to applications for which we will consider to be a good candidate.
Email *
Before we get started, please review the Terms and Conditions of Applying
The person completing and submitting this form (“Applicant”) understands that this is an application for consideration to be possibly hired as an employee with Day Company (“Employer”), and Applicant acknowledges and agrees to the terms and conditions contained in this Employment Application (“Application”), which are the sole terms and conditions of application. Applicant agrees that a credit and background check may be performed and information may be exchanged now and in the future between all relevant parties deemed so by Employer, the individual/organization and/or person who may engage Applicant for possible work. All information supplied by Applicant on this form, or any other form, agreement, or provision used by Employer is true and correct to the best of Applicant’s belief and knowledge. In the event that any information is found to be untrue, misleading, incorrect or false, Employer reserves the right to immediately terminate any relations with the Employee. Any engagement for any work or job would be by separate written Agreement. Employee agrees before (pre-employment screening) or during employment to be subject to a unscheduled and/or random drug and/or alcohol test at any time, and that the return of any test as positive shall be cause for immediate ending of any contract or denial of employment. All agreements in writing.
Damage Liability Waiver
Liability and Insurance
Employer assumes no responsibility, liability or other obligation towards Employee with reference to personal physical injury, loss, damage or other detriment, not due to Employer’s negligence (presumption is Employer is not negligent), other than that covered by the Employer’s Worker’s Compensation Insurance. Other than those conditions or situations covered by Employer’s Worker’s Compensation Insurance policy, Employee must carry his/her own personal health, medical, dental and/or liability insurance. Employer’s insurance company makes any determination regarding coverage for the employee; nothing in the foregoing sentence shall be construed as a waiver of any available legal rights and or remedies available to Employer, nor shall create any obligation, relationship or tie between the parties mentioned, other than at Employer’s sole discretion. This provision applies while Employee is physically at the Building and/or pursuant to the provision below while traveling to or from the property.
Operation of Power or Non-Power Equipment, Tools, or Other Devices, Mechanized or Non-Mechanical
Applicant agrees and understands that the use of power equipment, tools or other devices imparts a certain risk for which the Employer cannot be held liable should any injury, damage or detriment occur to Applicant, not due to Employer’s negligence. Applicant agrees and understands that it is his/her responsibility to read, learn and become familiar with the proper operation of any power equipment, tool or other device while undertaking any duty, responsibility or activity under the terms and conditions of this application. It is Applicant’s responsibility to study, read and understand the necessary instructions or guidance information that is or may be written about any power tool, equipment or other device. Such information may be located on the internet under the relevant power tool, equipment or other device manufacturer’s website, or a third party’s World Wide Web information site, or at a conventional library or other reference store house. It is the Applicant’s responsibility to either seek the proper instruction or obtain the necessary information to become familiar with the operation of any power or non-power equipment, tool, or other device.
Employer Not Responsible for Damage, Injury or Loss to Employee While Travelling To or From the Premises/Property
Employer shall not be responsible for any Damage, Injury or Loss to Employee when the Employee is performing any work, service or other activity in connection with the duties, responsibilities and work of the Employee while traveling to, from or between any premises/property in connection with obtaining supplies, undertaking projects or other activities.
Signature *
By typing your name below, you agree to all the conditions listed above.  Your typed name shall be the same as signing by hand.
Now let's start the application...
Personal Information
Let us know who you are.
Full First Name *
Full Middle Name *
Full Last Name *
Social Security Number *
Date of Birth *
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Cell Phone *
Current Street Address *
Current City *
Current State *
Current Zip Code *
Years at this address *
Previous street address *
Previous City *
Previous State *
Previous Zip Code *
Years at this address *
Is applicant a legal resident of the USA? *
Has applicant ever been convicted of a felony crime *
Required
Has applicant ever been convicted of a misdeameanor crime? *
Required
Has applicant any injuries *
Required
If applicant has injuries, please describe or list: *
For which work are you applying? *
If applicant is selected for employment, is applicant willing to submit to a pre-employment drug screen test? *
Domicile
Please provide information about your current living arrangements.
What is your living situation? *
If you live with someone else, please list their full name (Full First, Full Middle, Last Name), type of relationship and date of birth. *
What is your marital status?
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How many dependents, including a spouse, will you claim for the W-2 Form?
References
Please list the last two jobs/positions you have held
Most Recent Organiziation/Company Name *
Most Recent Supervisor/Individual Contact Name *
Most Recent Pay Rate Per Hour  
Most Recent Organiziation/Company Street Address *
Most Recent Organiziation/Company City, State and Zip Code *
Most Recent Job Description *
Most Recent Date Started Work/Job *
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DD
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Most Recent Date Ended Work/Job
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Previous Organiziation/Company Name *
Previous Supervisor/Individual Contact Name *
Previous Job Pay Rate Per Hour   *
Previous Organiziation/Company City, State and Zip Code *
Previous Organiziation/Company Street Address *
Previous Organiziation/Company City, State and Zip Code *
Previous Job Description *
Previous Date Started Work/Job *
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DD
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YYYY
Previous Date Ended Work/Job *
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DD
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YYYY
Signature *
By typing your name below, you agree to the terms and conditions of this Employment Application.  Your typed name shall be the same as signing by hand.
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