DeLucca Fence Company, Inc.

Application for Employment

DeLucca Fence Company, Inc is an Equal Opportunity Employer.

DeLucca Fence Company, Inc does not discriminate on the basis of age (as defined by applicable law), religion, sex, race, color, sexual orientation, national origin, disability, or veteran status. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

All questions must be answered fully and accurately. No action can be taken on this application until all questions have been answered.

Applicant Information:

Date:

Full Name:

Address:

City: State: Zip:

Telephone: Alternate Telephone Number:

Email:

Are you 18 years or older? Yes No

Are you legally permitted or otherwise authorized to work in the United States? Yes No
Proof of eligibility will be required at time of employment

Positions Applied for: Other:

Are you available for out of town work? Yes No

Are you available for shift work? Yes No

Are you available to be on call 24 hours/seven days a week if required by job? Yes No

How were you referred to DeLucca Fence Company, Inc.? Employment Ad Walk-in Other

DeLucca Fence Company, Inc. Employee Name:

Have you applied at DeLucca Fence Company, Inc. before? No Yes When?

Have you ever been employed at DeLucca Fence Company, Inc. in the past? No Yes
When and in what capacity?

Have you ever been convicted of a felony? Yes No
Conviction will not necessarily disqualify you from employment

If yes, please explain:

Driving Record:

Only complete if driving is a requirement of the job. All positions except Clerical could require driving.

Do you have a valid driver’s license? Yes No State: License Number:

Class: A B C D CDL When was CDL obtained?

Education and Training:

	School Name:	City, State:	No. of Years:	Degree/Diploma:	Area of Study:
High School:
College:
Trade/Technical:

Describe any other special training you have received:

Have you served an apprenticeship? Yes No How Long:

Trade:

Where was the apprenticeship served?

Employment History

Company Name:

Telephone:

Address

Starting Pay:

Last Rate of Pay:

Employment Dates:

To:

Supervisor's Name:

Phone:

Reason for Leaving (Be Specific):

Company Name:

Telephone:

Address

Starting Pay:

Last Rate of Pay:

Employment Dates:

To:

Supervisor's Name:

Phone:

Reason for Leaving (Be Specific):

Company Name:

Telephone:

Address

Starting Pay:

Last Rate of Pay:

Employment Dates:

To:

Supervisor's Name:

Phone:

Reason for Leaving (Be Specific):

Certification and Agreement:

It is very important that you read this section carefully and that you fully understand it before you submit it. This section affects your legal rights.

I certify that the information contained in this application is correct to the best of my knowledge and understand that any falsification, misrepresentation or omission on this application is ground for refusal to hire, or if hired, termination. I authorize any of the person or organizations referenced in this application to give DeLucca Fence Company, Inc. any and all information concerning my previous employment, education, or other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties and DeLucca Fence Company, Inc. from all liability for any damage that may result from furnishing such information. I authorize DeLucca Fence Company, Inc. to request and receive such information.
If employed, I understand that I will be an employee “at will” and either DeLucca Fence Company, Inc. or I may terminate my employment relationship at any time with or without notice for any reason that does not violate the law.
I agree to comply with DeLucca Fence Company, Inc’s rules, regulations and policies, and acknowledge that these rules, regulations and policies may be changed, interpreted, withdrawn or supplemented at any time, and without prior notice to me.
I acknowledge that any offer of employment, or my acceptance of an employment offer, if such is to occur, may be withdrawn with or without cause, and with or without prior notice, at any time, at the option of DeLucca Fence Company, Inc. or myself. I understand that this application and any other documents that I may receive are not contracts of employment. I further understand that no representative of DeLucca Fence Company, Inc. other than an officer has any authority to enter into any agreement for employment for any specified period of time or to assure other personnel action, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or make any agreement contrary to the foregoing.
I understand that I must meet the employability requirements of the Federal Immigration and Naturalization Service and submit appropriate documentation to satisfy the requirements for completing INS Form I-9.
- I understand and agree that work schedules and requirements vary and can be unpredictable, and that, while DeLucca Fence Company, Inc. will make reasonable efforts to accommodate work schedules and employee availability, I may be required to work overtime, weekends, different shifts or other agreements. I consent to these requirements as necessary and legitimate conditions of employment.

Click here for affirmative action information.

This certifies that this application was completed by me and that all entries on it and information in it are true and complete to the best of my knowledge.

DeLucca Fence Company, Inc.
Five Old Ferry Road, Methuen, Massachusetts 01844
Telephone: 978-688-2877 | Fax: 978-688-6030