Employment

Application

Applicants must be at least 18 years old and have a valid driver's license.
You can complete the Employment Application below or call us today.

Applicant Information

Full Name:*

Phone:*

Email:*

Preferred Contact Method: Select Phone Email

Driving Information

Do you currently possess a valid drivers license? Select Yes No

Has your drivers license ever been suspended or revoked? Select Yes No

Have you ever been cited for driving under the influence? Select Yes No

Drivers License Number:

Drivers License State: Select Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming

Drivers License Expires:

Previous Employment

Explain Any Gaps In Employment:

Have you ever been promoted?

Please list reasons for separating from your previous employers:

Job Inquiry

What position are you interested in?

What experience do you have in this field?

Please Describe Yourself to Us:

List Salary History:

By clicking "Submit Application", I certify that I have read and understand the D-Patrick Applicant Statement.

Applicant's Statement: Do not click "Submit Application" until you have read and understand this statement.

I understand that if I am hired, my employment will be for no definite period, regardless of the period of payment of my wages. I further understand that I have the right to terminate my employment at any time with or without notice, and the company has the same right. No one other than the President of the Company has authority to modify this relationship or make any agreement to the contrary. Any such modification or agreement must be in writing.

I understand that the company reserves the right to require me to submit to a drug test at any time and also reserves the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by law. I authorize the company to investigate my driving record, any criminal record, my credit history, and my educational background and I understand that an investigative consumer report may be prepared whereby information is obtained through personal interviews with neighbors, friends and others with whom I am acquainted. This inquiry would include information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

I further understand that the company may contact my current and previous employers and I authorize those employers to disclose to the company all records and other information pertinent to my employment with them. I also authorize the company to provide truthful information concerning my employment with it to my future prospective employers and I agree to hold it harmless for providing such information.

I certify that all of the information that I provide on this application and in any interview will be true and accurate. I understand that if I am employed and any such information is later found to be false or misleading in any respect, I will be dismissed.