CAREER

APPLICATION

INSTRUCTIONS: Thank you for your interest in employment with Webco Hawaii – 32971 (“COMPANY”). Please complete all portions of this employment application to be considered for employment at COMPANY. If you require accommodation during the employment application process, including assistance in the completion of this employment application, please let us know. We are an equal opportunity employer. We do not discriminate on the basis of age, race, sex, religion, color, national origin, ancestry, marital status, disability, sexual orientation, arrest and court record or any other protected category recognized by Hawaii and federal laws. This employment application is valid for a three-month period after submission to COMPANY and only for the desired position. Consideration for employment after the three-month period requires completion and submission of a new application.

For further information, please contact Human Resources at hr@awdhi.com.

I. PERSONAL INFORMATION:

Upon hire, you will be required to present proof of age, authorization to work and your social security number.

Last Name(Required)

First Name(Required)

Middle Initial

Have you ever used other names? If so, please print (For background and criminal conviction check)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Mobile Phone

Email Address(Required)

II. EMPLOYMENT INTEREST:

Position of Interest

Date You Can Start

Salary Requirement

Apart from religious observances, will you be able to work all other times?

Have you ever applied for employment at Webco before?

Where?

When?

Have you ever applied for employment at Webco before?

Where?

When?

Who referred you to Webco?

Friend/Relative

Employee

Employment Agency

Newspaper Advertisement

Walk-in

Other

Referrer's Name

*If hired, you will be required to perform work as required by Webco. *To be eligible for any employee incentives, employee referral name must be listed at time of application.

III. EDUCATION:

High school name and address

Did you graduate?

Degree/certification received; subjects studied

College name and address

Did you graduate?

Degree/certification received; subjects studied

Other school name and address

Did you graduate?

Degree/certification received; subjects studied

IV. FORMER EMPLOYERS:

Please account for the past five years of employment by answering all questions for each employer.
Type N/A in fields where inputs are not applicable.

Present Employer

Company Name(Required)

Phone(Required)

Address(Required)

Start Date & Date Last Worked(Required)

May we contact your supervisor? If not, why?(Required)

Supervisor Name, Title, Phone Number & Email(Required)

Summarize job responsibilities(Required)

Reason(s) for leaving(Required)

If you were terminated or asked to resign, please explain(Required)

Previous Employer 1

Company Name(Required)

Phone(Required)

Address(Required)

Start Date & Date Last Worked(Required)

May we contact your supervisor? If not, why?(Required)

Supervisor Name, Title, Phone Number & Email(Required)

Summarize job responsibilities(Required)

Reason(s) for leaving(Required)

If you were terminated or asked to resign, please explain(Required)

Previous Employer 2

Company Name(Required)

Phone(Required)

Address(Required)

Start Date & Date Last Worked(Required)

May we contact your supervisor? If not, why?(Required)

Supervisor Name, Title, Phone Number & Email(Required)

Summarize job responsibilities(Required)

Reason(s) for leaving(Required)

If you were terminated or asked to resign, please explain(Required)

V. EMPLOYMENT GAPS:

Explain any periods that you were not working during the past 10 years, other than due to personal illness, injury, or disability.(Required)

VI. REFERENCES:

List name and telephone number of three business/work references who are NOT related to you and are NOT previous supervisors. If not applicable, list three personal references who are NOT related to you.

Reference Name 1

Title

Relationship to you

Phone

Years Known

Please enter a number less than or equal to 100.

Reference Name 2

Title

Relationship to you

Phone

Years Known

Please enter a number less than or equal to 100.

Reference Name 3

Title

Relationship to you

Phone

Years Known

Please enter a number less than or equal to 100.

VII. JOB SKILLS AND QUALIFICATIONS:

Summarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying. If driving is required for the job you are applying for, please provide your valid driver’s license number, expiration date, and state of issuance.(Required)

VIII. RELATED INFORMATION:

If you are a member of any job-related organizations (professional, trade, etc.) or have received any job-related awards or accomplishments, list and describe them. Exclude any information that would reveal your age, race, sex, religion, color, national origin, ancestry, marital status, disability, sexual orientation, arrest and court record or any other protected category recognized by Hawaii and federal laws.(Required)

CERTIFICATION:

(Please read carefully before signing).

I understand and agree that:(Required)

1. The information in this application is true and complete and that any false or misleading information made in this application or interview(s) are grounds for disqualification from further consideration for employment or for dismissal from employment.

2. This application is not a contract of employment. If offered employment, MY EMPLOYMENT WITH COMPANY IS AT-WILL AND CAN BE TERMINATED AT ANY TIME AND FOR ANY REASON WITH OR WITHOUT ADVANCE NOTICE BY MYSELF OR THE COMPANY.

3. The Company may investigate my personal and/or employment history. Any former employer, school, government agency, or other person/entity may provide the Company with any information they may have regarding me. If employed by the Company, the Company may provide truthful information (including fact or opinion) regarding my employment to any potential or future employer. I release the Company and all providers of such information from any liability which may arise as a result of furnishing and/or receiving such information.

4. I may be required to submit to drug testing and a post-offer medical examination as part of my application for employment. I may be required to submit to a medical examination during my employment with the Company, provided that such examination is job-related and consistent with business necessity. I authorize the physician or laboratory conducting such examination to disclose the results of the examination to the Company in accordance with state and/or federal laws. The Company will keep such results confidential unless allowed/required by law.

5. The Company may inquire into and consider any criminal conviction record that I may have after it makes a conditional offer of employment. The Company may withdraw a conditional employment offer if I have a criminal conviction record which bears a rational relationship to the duties and responsibilities of the position for which I am applying. Any criminal conviction record that is more than 10 years old (excluding periods of incarceration) or that involves certain Family Court matters will not be considered.

6. If hired, I shall not disclose or use confidential information belonging to prior employers and that I will inform Company of any agreements that would limit my ability to work for the Company.

7. All of the foregoing terms and conditions will become part of my employment relationship with Company if I am employed by the Company.

I agree to the above statement.

Type Your Name(Required)

Date(Required)

Attach a Resume(Required)

Max. file size: 50 MB.

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