• An Equal Opportunity Employer. We consider applications for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, sexual orientation, citizen status, genetic ininformation or any other legally protected status.
  • PERSONAL INFORMATION

  • GENERAL INFORMATION

  • A conviction record will not necessarily negate your chances of employment. Factors such as job relations, age, time of offense, seriousness, nature of violation, and rehabilitation will all be considered.
  • IF YOU HAVE ANY QUESTIONS CONCERNING THE POSITION, PLEASE ASK THE INTERVIEWER BEFORE ANSWERING.
  • JOB INTEREST

  • Date Format: MM slash DD slash YYYY
  • Please check all that apply.
  • Conditions of employment are listed at the end of this form. Please read carefully before you sign this application. Application must be completed in full even if attaching a resume. Job applications are considered active for 60 days, after which, the applicant must reapply for further consideration.
  • EMPLOYMENT HISTORY

  • Begin with your most recent employment, continuing with your past employment for the last 5 years. All Driver Applicants must provide information on all previous employers for the last three years. List the complete mailing address including street number, city, and zip code. Applicants driving a commercial motor vehicle in interstate or intrastate must provide an additional 7 years of information.
  • DRIVING INFORMATION

  • Any applicant applying for a position requiring driving must complete the following section. Accident record for the previous 5 years.
  • Driving Incidents:

  • Traffic Convictions for the last 3 years:

  • Driving Experience:

  • Straight Truck:
  • Tractor & Semitrailer:
  • Tractor & Two Trailers:
  • Tractor & Triple Trailers:
  • EDUCATION

  • REFERENCES

  • ADDITONAL QUALIFICATIONS OR EXPERIENCE

  • List any other Skills, Qualifications, or Experience you believe will help you in being considered for the position you applied for.
  • Conditions of employment are listed at the end of this form. Please read carefully before you sign this application. Application must be completed in full even if attaching a resume. Job applications are considered active for 60 days, after which, the applicant must reapply for further consideration.
  • NOTIFICATION AND AGREEMENT

  • I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE, AND COMPLETE. I UNDERSTAND THAT THE FALSIFICATION, MISREPRESETNATION, OR OMISSION OF FACT ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED. Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed. It is the policy of Lee Supply Company, Inc. to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State, or Local law. I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation. I hereby certify that all the facts and information listed on this employment application are true and complete. I understand that any false, incomplete, or misleading information given by me on this application is sufficient cause for rejection of this application. I also understand and agree that any such false, incomplete, or misleading information discovered on this application at any time after I am employed my result in dismissal. If I am offered employment, I understand that such an offer will be conditioned upon satisfactory results of a background investigation and/or company medical examination or inquiry, including a drug-screening test. I consent to the investigation, physical and drug test. I hereby authorize Lee Supply Company, Inc. to investigate all statements contained in this application, to interview the references and previous employers listed in the application (unless otherwise noted), and to obtain a report from a consumer- reporting agency to be used for employment purposes in accordance with the Fair Credit Reporting Act. I authorize the references and previous employers listed to give Lee Supply Company, Inc. all facts, opinions, and evaluations concerning my previous employment and any other information they may have, personal or otherwise, and release all such information to Lee Supply Company, Inc., including, but not limited to, any liability or invasion of privacy. I understand that I will be provided with a separated consent form authorizing a consumer report and/or investigative consumer report. If I am applying for a position as a driver with Lee Supply Company, Inc., I understand that information I provide regarding current and/or previous employers may be used, and those employers contacted for investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to: a) Review information provided by previous employers; b) Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer, and; c) Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. In consideration of my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice at any time by the company. I further understand and voluntarily agree as a condition of employment or my continued employment, that I may be requested by Lee Supply Company, Inc. to submit to a urinalysis or other drug screen test and that my failure to take such test(s) when requested to do so or unsatisfactory test results will disqualify me from consideration for employment, or if I am then employed, may result in immediate dismissal. I acknowledge that I have a valid driver’s license in one of the 50 United States. I acknowledge that I have read and understand the above statements and herby grant permission to confirm the information supplied on this application by me.
  • Date Format: MM slash DD slash YYYY
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