OSS EVS EMPLOYMENT APPLICATION

* INDICATE REQUIRED INPUT

TO EMPLOYER:

OSS EVS LLC
229 TIMBERLY DR,
LAKE CHARLES LOUSISANA, 70605
TELE: 337-936-0886

IT IS THE POLICY OF OSS EVS LLC TO PROVIDE EQUAL OPPORTUNITY TO ALL APPLICANTS AND EMPLOYEES WITHOUT REGAUARD TO ANY LEGALLY PROTECTED STATUS SUCH AS RACE, COLOR, RELIGION, GENDER, NATIONAL ORGIN, AGE, DISABILITYOR VETERAN STATUS.

APPLICATION:

FULL NAME*

FULL ADDRESS*

YEARS AT ADDRESS*

TELEPHONE* EMALL ADDRESS*

SOCIAL SECUTIRY NUMBER* DRIVER LICENSE NUMBER*

DATE OF BIRTH*;

ARE YOU A U.S. CITIZEN(Y/N)* IF NOT A U.S. CITIZEN

CAN YOU PROVIDE LEGAL PROOF YOU ARE ELIGIBLE FOR EMPLOYMENT IN THE U.S.(Y/N)*

DO YOU HAVE TRANSPORTATION(Y/N)* ARE YOU WILLING TO WORK SHIFTS(Y/N)*

ARE YOU WILLING TO WORK OVERTIME(Y/N)* WHAT DATE ARE YOUR AVALAIBLE TO START WORK*

EDUCATION:

LIST YOUR DAPLOMAS AND DEGREES*

PLEASE LIST ANY PROFESSIONAL LICENSE AND CERTIFICATIONS THAT YOU HOLD.

PROFESSIONAL LICENSES AND CERTIFICATIONS

MILITARY SERVICE(Y/N)* BRANCH OF SERVICE TYPE OF DISCHARGE

SPECIALIZE TRAINING

ARE YOU ABLE TO PERFROM THE ESSENTIAL FUNCTIONS OF THE JOB POISTION YOU SEEK
WITH OR WITH REASONABLE ACCOMENDATION? (Y/N)
IF NO, WHAT REASONABLE ACCOMMENDATION IF ANY WOULD YOU REQUEST?

CHECK THOSE SKILL THAT YOU HAVE, lIST ANY OTHER SKILL THAT MAY BE USEFUL FOR THE JOB YOU ARE SEEKING. ENTER THE NUMBER OF YEARS OF EXPERIENCE AND RATE YOUR ABILITY AND SKILL SET.
1 = MINIMAL, 2 = MARIGNAL, 3 = AVERAGE, 4 = GOOD, 5 = EXCEPTIONAL

SKILL YEAR OF EXPERIENCE RATING (1 TO 5)

CUSTOMER SERVICE? (Y/N)

JANITORIAL SKILLS(? Y/N)

OTHER SKILLS

EMPLOYMENT:

CURRENT OR MOST RECENT EMPLOYMENT

EMPLOYER NAME:

ADDRESS:

SUPERVISOR NAME , TELEPHONE NUMBER: MAY WE CONTACT YOUR EMPLOYER? (Y/N)

DATE OF EMPLOYMENT: REASON FOR LEAVING:

DUTIES:(2000)

PREVIOUS EMPLOYMENT 1

EMPLOYER NAME:

ADDRESS:

SUPERVISOR NAME , TELEPHONE NUMBER MAY WE CONTACT YOUR EMPLOYER? (Y/N)

DATE OF EMPLOYMENT: REASON FOR LEASON:

DUTIES:(2000)

PREVIOUS EMPLOYMENT 2

EMPLOYER NAME:

ADDRESS:

SUPERVISOR NAME , TELEPHONE NUMBER MAY WE CONTACT YOUR EMPLOYER? (Y/N)

DATE OF EMPLOYMENT: REASON FOR LEASON:

DUTIES:(2000)

REFERENCES:

LIST AT LEAST TWO REFERENCES
MUST CONTAIN FULL NAME, FULL ADDRESS, TELEPHONE, AND RELATIONSHIP TO YOU TWO REFERENCES MAYBE YOUR RELATIVES.

REFERENCE(300)*

REFERENCE(300)

CERTIFICATION:

I CERTIFY THAT THE INFORMATION PROVIDED ON THIS APPLICATION IS TRUTHFUL AND ACCURATE. I UNDERSTAND THAT PROVIDING FALSE OR MISLEADING INFORMATION SHALL QUALIIFY THE APPLICATION FOR REJECTION, OR IMMEDIATE TERMINATION OF EMPLOYEMENT AFTER EMPLOYMENT HAS COMMENSED.

I AUTHORIZED OSS EVS LLC TO CONTACT FORMER EMPLOYERS AND EDUCATIONAL ORGANIZATIONS REGUARDING MY EMPLOYMENT AND EDUCATION. I AUTHORIZE MY FORMER EMPLOYERS AND EDUCATIONAL ORGANIZATIONS TO FULLY AND FREELY COMMUNICATE INFORMATION REGARDING MY PREVIOUS EMPLOYMENT TTENDANCE, AND GRADES. UNLESS OTHERWISE INDICATED ON APPLICATION. I AUTHORIZE THOSE PERSONS DESIGNATED AS REFERENCES TO FULLY AND FREELY COMMUNICATE INFORMATION REGARDING MY PREVIOUS EMPLOYMENT AND EDUCATION.

IF AN EMPLOYMENT RELATIONSHIP IS ESTABLISHED, I UNDERSTAND THAT UNLESS I AM OFFERED A SPECIFIC WRITTEN CONTRACT OF EMPLOYMENT SIGNED ON BEHALF OF THE ORGANIZATION BY THE CEO, THE EMPLOYMENT RELATIONSHIP WILL BE "AT-WILL". IN OTHER WORDS, THE RELATIONSHIP SHALL BE ENTERILY VOLUNTARY IN NATURE, AND EITHER I OR THE EMPLOYER SHALL BE ABLE TO TERMINATE THE EMPLOYMENT RELATIONSHIP AR ANY TIME, WITHOUT CAUSE. WITH APPROPRIATE NOTICE, I SHALL HAVE THE FULL AND COMPLETE DISCRETION TO END THE EMPLOYMENT RELATIONSHIP WHEN I CHOOSE AND FOR REASONS OF MY CHOICE. SIMILARY, MY EMPLOYER SHALL HAVE THE SAME RIGHT. MOREOVER, NO AGENT, REPRESENTATIVE, OR EMPLOYEE OF OSS EVS LLC. EXCEPT IN A SPECIFIC RITTEN CONTRACT OF EMPLOYMENT SIGNED ON BEHALF OF THE ORGANIZATION BY ITS CEO, HAS THE POWER TO ALTER OR VARY THE VOLUNTARY NATIRE OF THE EMPLOYMENT RELATIONSHIP.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO IT TERMS.

SIGN YOUR FULL NAME* DATE:*
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