General Information

* First Name:

* Last Name:

* Telephone:

Email:

* Date of Application:

Present Address

* Street:

* City:

* State:

* Zip:

Prior Address - If you have resided at your present address less than three years, list your prior address.

*Street:

City:

State:

Zip:

More Information

* Position(s) Desired:

* Salary Expected:

* Are you available to work:

Full Time
On-Call

Part Time
Overtime

Temporary
Any Shift

* On what date would you be available to work:

* Are you on a layoff and subject to recall at another employer?

Yes No

* Are you 18 years or older?

Yes No

* Have you filed an application here before?

Yes No

If yes, give date(s):

* Have you ever been employed here before?

Yes No

If yes, give date(s):

* Do you have any relatives or friends that are employed here?

Yes No

If yes, please list them by name and relationship:

* Why did you apply for a position at Hull?

* Why do you think you would make a valuable employee at Hull?

* Are you legally authorized to work in the United States?

Yes No

* Will you now or in the future require sponsorship for employment visa status (e.g. H-1B visa status)?

Yes No

* Have you been convicted of or pled guilty to a felony or misdemeanor other than a minor traffic-related infraction? (A conviction or plea will not necessarily disqualify you from consideration for employment. The effect of a conviction will be assessed with respect to time, circumstances, seriousness of the offense, and job responsibilities and duties. However, your failure to list a conviction will disqualify you from consideration for employment or will result in termination of employment if subsequently discovered.

Yes No

If yes, state the nature of the conviction or plea, the date, and explain:

Emergency Contact Information

* Name of person to notify in case of emergency:

* Street:

* City

* State:

* Phone Number:

Education

List any special job-related skills, software, and qualifications acquired from education, employment, volunteer work or military service:

List specific skills or office machines, tools, machinery or other equipment that you are trained on and can operate that will be helpful in performing the responsibilities of the position(s) for which you are applying:

* Personal References: List the name, address and telephone number of three references who are not related to you and are not previous employers.

* Name

* Address

* Phone

Employment Record: Starting with your present or most recent job, list all your employment experience for at least the last 15 years. You may include job-related military service assignments and volunteer activities that reflect your qualifications for employment.

Employer 1 Information

Name:

Immediate Supervisor:

Telephone:

Job Title:

Street:

City:

State:

Zip:

Employment Dates

From:

To:

Salary/Hourly Rate

Starting:

Final:

Kind of Work Performed

Employer 2 Information

Name:

Immediate Supervisor:

Telephone:

Job Title:

Street:

City:

State:

Zip:

Employment Dates

From:

To:

Salary/Hourly Rate

Starting:

Final:

Kind of Work Performed

Employer 3 Information

Name:

Immediate Supervisor:

Telephone:

Job Title:

Street:

City:

State:

Zip:

Employment Dates

From:

To:

Salary/Hourly Rate

Starting:

Final:

Kind of Work Performed

Employer 4 Information

Name:

Immediate Supervisor:

Telephone:

Job Title:

Street:

City:

State:

Zip:

Employment Dates

From:

To:

Salary/Hourly Rate

Starting:

Final:

Kind of Work Performed

Finalizing

May we contact the employers listed above?

Yes No

If no, which one(s) do you NOT wish us to contact and state the reason why you prefer that we do not contact the employer(s).

Have you ever been discharged, permitted to resign rather than be discharged, or asked to resign from any position?

Yes No

If yes, please state the employer and the reason for the discharge or resignation.

Which of your previous jobs have you liked best?

Why?

Which of your previous jobs have you liked least?

Why?

* Applicant's Statement (Please indicate that you have read and understand each paragraph of the Applicant’s Statement by placing your checking the boxes beside each paragraph.)

I certify that this application was completed by me and that all entries and information in it are TRUE and COMPLETE to the best of my knowledge. I understand that false, misleading or omitted information in my application may result in the rejection of my application, the revocation of an offer of employment, or discharge.

I authorize investigation of all statements contained in this application as may be necessary in arriving at an employment decision. I understand that an investigation may be made and information may be obtained through interviews with personal references and past employers, through a credit check, a criminal history check and/or a driver’s record check. This inquiry may include information as to, among other things, my character, general reputation and personal characteristics, as well as information about my work performance and workplace conduct. I consent to this investigation and to the consideration of any statements of references, former employers or others that are given in response to the inquiry. If HULL decides to obtain a consumer credit report, I understand that HULL will provide, at my request, the name and address of the reporting agency so I may obtain from such reporting agency the nature and substance of information contained in such report.

I hereby release all parties, including but not limited to HULL personal references and previous employers, from liability for any injury or damage that may result from their furnishing information concerning me or any action HULL takes on the basis of such information.

I understand that, if I am offered a job, as a condition of beginning my employment, I may be required to undergo a physical examination and drug screen, and I hereby authorize any doctor, hospital, clinic, laboratory and/or other medical facility to furnish any medical information with reference to me as may be necessary in conjunction with that examination and related considerations.

I understand that, according to federal law, all individuals who are hired must, as a condition of employment, produce certain documentation to verify their identity and United States citizen status or, if aliens, their legal authorization to work in the United States. As a consequence, I understand that any offer of employment to me is contingent upon my ability to produce the required documentation within the time period required by law.

I understand that this application is not, and is not intended to be, a contract of employment and that any resulting employment is for no fixed period of time and is terminable at any time and for any reason by me or by HULL. I further understand that statements which may be contained in policies, practices, handbooks or other material do not create any guarantee of employment and that HULL has the right to modify, amend or terminate policies, practices, benefits plans or other programs within the limits and requirements imposed by law. I understand that no representative of HULL, other than an officer, has the authority to enter into any agreement for any specific period of time or to make any agreement contrary to the foregoing and that any such agreement must be in writing to be binding.

I understand that, upon employment, I will sign an agreement relating to confidential information, if required.

I certify that I am not bound by any employment contract or non-competition agreement that would be breached by any employment that might be offered to me by the Company, nor am I in possession of nor will I at any time reveal to the Company, under any circumstances, any proprietary or confidential information that is the subject of any contract, non-disclosure agreement or prior work relationship involving any other person or entity.