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IMPORTANT! Please Read Carefully Before Completing Application

Please read and answer every question in this application yourself, as completely and accurately as possible. If you require another person type, write, or print the answers to the questions for you, you must take every measure to ensure the information provided is accurate to the best of your knowledge and ability. Despite having someone else input the information into the application, you must sign the application yourself for the application to be considered valid. However, having another person assist with completing the application should only be done as a reasonable accommodation.

Do not leave any answers blank. “See Resume” is not an acceptable response to any of the questions; however, a resume may be attached. An unsigned or incomplete application will not be processed.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Alianza is an Equal Opportunity Employer. It is the policy of Alianza to afford equal employment opportunity to all qualified persons without regard to membership in a legally protected class such as race, color, religion, sex, sexual orientation, national origin, gender identity, ancestry, age, genetic information, pregnancy, pregnancy-related conditions, qualified handicap or disability, veteran status or any other category protected by applicable federal, state, or local law in the jurisdiction of the position to which you are applying. Alianza is committed to providing a reasonable accommodation if necessary to perform the essential functions of the job. If you require an accommodation in order to participate in any phase of the application process, because of a physical or mental disability, please make that fact known and a reasonable accommodation shall be made.

Name
Address
Apart from absence for religious observance, are you available for full-time work?
See previous question.
Are you legally eligible for employment in the United States?
Will you work overtime if asked?
MM slash DD slash YYYY
Are you over 18 years of age?
If not, employment is subject to verification of minimum legal age.

Education

Did you graduate?
Achievement
Did you graduate?
Achievement

Employment #1

Please give accurate, complete full-time and part-time employment record. Stat with present or most recent employer.
Address
MM slash DD slash YYYY
MM slash DD slash YYYY

Employment #2

Please give accurate, complete full-time and part-time employment record. Stat with present or most recent employer.
Address
MM slash DD slash YYYY
MM slash DD slash YYYY

Employment #3

Please give accurate, complete full-time and part-time employment record. Stat with present or most recent employer.
Address
MM slash DD slash YYYY
MM slash DD slash YYYY

Employment #4

Please give accurate, complete full-time and part-time employment record. Stat with present or most recent employer.
Address
MM slash DD slash YYYY
MM slash DD slash YYYY

For Commercial Driver Applicants Only

Were you subject to the FMCSRs while employed here?
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Permission On Contact

We may contact the employers listed above unless you indicate those you do not want us to contact.

Complete This Section If You Served In The U.S. Armed Forces

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MM slash DD slash YYYY
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Job References

List three (3) persons for references, other than family members, who have knowledge of your character and your qualifications for the position. Those applying for commercial driver positions must list references who have knowledge of your safety habits to be considered for such positions.

Reference #1

Reference #2

Reference #3

Acknowledgement & Authorization

Please read all the information in this section and then sign in the indicated area. This will allow Alianza to accept and retain this application. I hereby certify that the information given in this Application for Employment has been given by me, or someone else at my direction as a reasonable accommodation, and that each entry made by me, or someone else at my direction, is true and complete to the best of my knowledge and understanding. I understand that the making of false, misleading or incorrect statements, including material omissions will be sufficient cause for immediate termination upon discovery thereof regardless as to when discovered, if employed by Alianza; or that no further consideration for employment will be given to me, if an applicant or if seeking rehire or reinstatement. If employed by Alianza, I agree to abide by its rules, policies and regulations, as they exist or as they may be modified or amended from time to time. I understand that neither this application form, nor any other communication by Alianza representatives, written or oral, is intended in any way to create an employment contract binding on either party and that no one other than the President of the Company has any authority to make a contract regarding any benefit, condition or term of employment with me or to make any expressed or implied commitment, concerning benefits, conditions or terms of employment that differ from the published Alianza policy or that is to serve as an individual arrangement in the absence of published company policy. I understand that representations made by the President of the Company are only binding if made in writing. I acknowledge that if employed, I am employed at will and my employment and compensation may be terminated, with or without cause, and with or without notice, at any time at the option of either Alianza or myself unless there is a collective bargaining agreement or an individual agreement with other provisions to which my employment is subject. I authorize Alianza to make inquiry of any of my present (unless otherwise noted) or former employers or references, as to my employment, compensation, experience, job suitability, education, or reasons for leaving; and any inquiry to any other agency, institution, or person about any information provided by me in this, my Application for Employment, or during any interview that I may be given. I authorize persons listed as references or previous employers (unless otherwise noted) to provide information concerning me to Alianza. I further authorize Alianza to conduct an Internet search regarding any information provided by me in this, my Application for Employment, or during any interview that I may be given. I release any such source and Alianza from any liability regarding information of a truthful nature that may be obtained by Alianza. Information in violation of state or federal fair employment practice laws will not be sought or used by Alianza. If I am extended a conditional offer of employment, I agree to take a physical examination, including tests to determine drug or alcohol use, when required by Alianza, at no personal expense and I further agree that the examining physician may disclose to Alianza or its representatives the results of such examination. If I am extended a conditional offer of employment, I understand that Alianza may conduct an inquiry into my criminal history or other background information relevant to the position sought. If I am extended a conditional offer of employment, I understand that Alianza may conduct an inquiry into my criminal history or other background information deemed relevant to the position sought, including any physical restrictions that may preclude my ability to perform the essential functions of the offered position without a reasonable accommodation. An applicant for employment with a record expunged pursuant to section 100F, section 100G, section 100H or section 100K of chapter 276 of the General Laws may answer ‘no record’ with respect to an inquiry herein relative to prior arrests, criminal court appearances or convictions. An applicant for employment with a record expunged pursuant to section 100F, section 100G, section 100H or section 100K of chapter 276 of the General Laws may answer ‘no record’ to an inquiry herein relative to prior arrests, criminal court appearances, juvenile court appearances, adjudications or conviction I understand that if I am employed, I will be required to show proof of citizenship or other evidence to show that I have an unrestricted legal right to work in the United States. 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.
Consent
Please type your full name if all of the information provided is accurate.
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.