Apply – Production Position – Harriss & Covington

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Position Desired

What position are you applying for?*

Personal Information

Today's Date*

Are you over 18 years of age?*

Yes

Name*

First Last

Email Address*

Mobile Phone #*

Present Address*

Street Address Address Line 2 City State ZIP Code

Have you been convicted of a crime outside of a minor traffic violation?*

Yes

Please explain offense and final disposition

Required if you answered Yes above.

Have you been previously employed with Harriss & Covington Hosiery Mills?*

Yes

If offered employment, are you willing to submit to a Drug Screening & Pre-Employment Physical?*

Yes

Employment Desired & Availability

Are you legally employable within the United States at the present time?*

Yes

Date You Can Start

Can Work Overtime?

Yes

Can Work Weekends?

Yes

Can Work Holidays?

Yes

Shifts Available to Work*

1st Shift

2nd Shift

3rd Shift

Monday — Available From

Monday — Available To

Tuesday — Available From

Tuesday — Available To

Wednesday — Available From

Wednesday — Available To

Thursday — Available From

Thursday — Available To

Friday — Available From

Friday — Available To

Saturday — Available From

Saturday — Available To

Sunday — Available From

Sunday — Available To

Referral Source

How did you hear about us?

Walk In

Referral

Other

If referred by an active H&C employee, please list their name:

Education

High School — Name of School

High School — Course of Study

High School — Years Attended

High School — Diploma or Degree Received

Trade/Technical School — Name of School

Trade/Technical School — Course of Study

Trade/Technical School — Years Attended

Trade/Technical School — Diploma or Degree Received

College/University — Name of School

College/University — Course of Study

College/University — Years Attended

College/University — Diploma or Degree Received

Employment History

Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards. Incomplete information could disqualify you from further consideration.

Employer 1 (Most Recent) — Name of Employer

Employer 1 (Most Recent) — Job Title

Employer 1 (Most Recent) — From (MM/YYYY)

Employer 1 (Most Recent) — To (MM/YYYY)

Employer 1 (Most Recent) — Describe Work Performed

Employer 2 — Name of Employer

Employer 2 — Job Title

Employer 2 — From (MM/YYYY)

Employer 2 — To (MM/YYYY)

Employer 2 — Describe Work Performed

Employer 3 — Name of Employer

Employer 3 — Job Title

Employer 3 — From (MM/YYYY)

Employer 3 — To (MM/YYYY)

Employer 3 — Describe Work Performed

Certification & Signature

I UNDERSTAND THAT NEITHER THE COMPLETION OF THIS APPLICATION NOR ANY OTHER PART OF MY CONSIDERATION FOR EMPLOYMENT ESTABLISHES ANY OBLIGATION FOR H&C TO HIRE ME. IF I AM HIRED, I UNDERSTAND THAT EITHER H&C OR I CAN TERMINATE MY EMPLOYMENT AT ANY TIME AND FOR ANY REASON, WITH OR WITHOUT CAUSE AND WITHOUT PRIOR NOTICE. I UNDERSTAND THAT NO REPRESENTATIVE OF H&C HAS THE AUTHORITY TO MAKE ANY ASSURANCE TO THE CONTRARY. I ATTEST THAT I HAVE GIVEN TRUE AND COMPLETE INFORMATION ON THIS APPLICATION. IF EXTENDED AN OFFER OF EMPLOYMENT, I AUTHORIZE H&C TO CONDUCT A PRE-EMPLOYMENT SCREENING, WHICH CAN INCLUDE REFERENCES, CREDIT CHECK, EDUCATIONAL HISTORY, CRIMINAL CHECK AND A PRE-EMPLOYMENT DRUG SCREEN & PHYSICAL. FAILURE TO REVEAL ANY PRIOR EMPLOYER OR GIVING FALSE INFORMATION MAY BE GROUNDS FOR DISQUALIFICATION OR TERMINATION. THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE ABOVE.

Certification*

I certify that the information contained in this application is correct to the best of my knowledge and I agree to the terms above.

Full Name (as signature)*

Date*

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