Employment Application - Equipment Rental – Lift RentalEquipment Rental

Position or Type of Work You Desire*

Name*

Last

First Middle

Address*

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

Phone*

Email*

Enter Email Confirm Email

Are you legally eligible to work in the United States?*

Yes
No

Have you been employed by Duke previously?

Yes
No

From

To

How were you referred to Duke?

Are you available for full-time work?

Yes
No

Check days available for work:

List hours available for work:

If necessary, are you available for overtime work?

Yes
No

Have you ever been known by any other name(s) which Duke Rentals may require to verify any of the information in this application?

Yes
No

Please list below and note your previous name(s) clearly as related to each school, employer, etc., (Ex: "known as Jane Smith") in the following EDUCATION and past EMPLOYMENT sections.

Education - High School

Name/Location of School

Course of Study

Years Completed

Type of Degree or Diploma

Did you Graduate?

Yes
No

Education - Business, Trade, Technical

Name/Location of School

Course of Study

Years Completed

Type of Degree or Diploma

Did you Graduate?

Yes
No

Education - College

Name/Location of School

Course of Study

Years Completed

Type of Degree or Diploma

Did you Graduate?

Yes
No

Education - Graduate School

Name/Location of School

Course of Study

Years Completed

Type of Degree or Diploma

Did you Graduate?

Yes
No

Additional Experience

Do you have training and/or experience in welding, industrial painting, fabricating or assembling (mechanical, electrical, hydraulic)? If yes, please give dates and details of training and/or experience.

Yes
No

Other specialized skills, licenses, or training (workshops, seminars, short sources, etc)? If yes, lease give dates and details

Yes
No

Employment

Please give accurate, complete information regarding your previous employment or military history. List most recent entries first. Please explain any gaps in time.

Employment - Most Recent

Company Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Employed From:

(Mo/Yr) - (Mo/Yr)

Supervisor Name

Contact Phone

May we contact this employer?

Yes
No

Job Title, Description, Summary of Equipment Used

Final Wage/Salary

Reason for Leaving

Employment - Second Most Recent

Company Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Employed From:

(Mo/Yr) - (Mo/Yr)

Supervisor Name

Contact Phone

May we contact this employer?

Yes
No

Job Title, Description, Summary of Equipment Used

Final Wage/Salary

Reason for Leaving

Employment - Third Most Recent

Company Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Employed From:

(Mo/Yr) - (Mo/Yr)

Supervisor Name

Contact Phone

May we contact this employer?

Yes
No

Job Title, Description, Summary of Equipment Used

Final Wage/Salary

Reason for Leaving

Other Information

Please list Duke employees you know:

Please list any additional information about you and/or your past work, training, or personal experience that you would like us to consider:

References

Please name three work or business references who are not personally related to you and who are not previous supervisors. If not possible, use school or personal references who are not related to you.

Name

How Known by You

Years Known

Contact Phone #

Name

How Known by You

Years Known

Contact Phone #

Name

How Known by You

Years Known

Contact Phone #

Applicant Signature

I attest that the above information is true, correct and complete. If I am employed, I understand that and falsified statements or omissions of fact on this application shall be sufficient cause for dismissal.

I hereby authorize my former employers, educational institution and references to furnish or verify any information concerning my application for employment. I further authorize Duke Aerial Equipment to contact my former employers, education institutions and references for the purpose of obtaining such information (unless previous stated in writing to the contrary). I further release all former employers, educational institutions, references and Duke Aerial Equipment from all liability in providing or obtaining this information

I understand that Duke Aerial Equipment, or I can terminate at any time and for any reason my employment with no representative of the employer authorized to make oral assurances to the contrary. This application does not constitute an agreement or contact of employment for any specified period or duration of time,

If I am employed, I further understand that I am required to abide by all rules and regulations as set for by Duke.

I agree, as a condition of employment, to provide documents establishing proof of identity and employment eligibility in compliance with the Immigration Reform and Control Act of 1986.

I have read and fully understand the foregoing and seek employment under these conditions

Date*

Signature*

Phone

This field is for validation purposes and should be left unchanged.