Preliminary Employment Application
Florida Highway Products. Inc.
3900 US Hwy 17 N. Bartow, FL 33830
Date:
Name:
Address:
How Long? (Months/Years):
City:
State:
Zip:
County:
Phone:
Cell:
Position Applying for:
How did you hear about us:
D O B:
SS#:
DL#:
Class:
State:
Endorsement:
Have you ever failed or refused drug or alcohol test, including pre-employment:
Select Answer
No
Yes
If Yes, When:
Any Points on D.L.?
If yes, explain:
Select Answer
No
Yes
In past 7 yrs Any crashes?
If yes, explain:
Select Answer
No
Yes
Rear-end accident?
When:
Roll-over:
When:
Select Answer
No
Yes
Select Answer
No
Yes
Have you been convicted of DUI:
Select Answer
No
Yes
If Yes, When/where:
CDL
EVER
suspended or revoked:
Select Answer
No
Yes
If Yes, Explain: Why, duration, location:
Have you been convicted of a Felony:
Select Answer
No
Yes
If Yes, explain:
Unemployed?
Select Answer
No
Yes
How long since last worked:
Present Employment:
City/State:
Position:
From:
To:
Reason for leaving:
Previous Employment:
City/State:
Position:
From:
To:
Reason for leaving:
Next Previous Employment:
City/State:
Position:
From:
To:
Reason for leaving:
