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Application for Employment
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Company
This field is for validation purposes and should be left unchanged.
Position Desired
What position are you applying for?
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Personal Information
Today's Date
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MM slash DD slash YYYY
Are you over 18 years of age?
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Yes
No
Name
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First
Last
Email Address
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Mobile Phone #
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Present Address
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Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Have you been convicted of a crime outside of a minor traffic violation?
*
Yes
No
Please explain offense and final disposition
Required if you answered Yes above.
Have you been previously employed with Harriss & Covington Hosiery Mills?
*
Yes
No
If offered employment, are you willing to submit to a Drug Screening & Pre-Employment Physical?
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Yes
No
Employment Desired & Availability
Are you legally employable within the United States at the present time?
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Yes
No
Date You Can Start
MM slash DD slash YYYY
Can Work Overtime?
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Yes
No
Can Work Weekends?
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Yes
No
Can Work Holidays?
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Yes
No
Shifts Available to Work
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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
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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
*
MM slash DD slash YYYY
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