RS Electric Motor eApplication

RS Electric Motors Sales & Service 800-279-2267

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Position Information

Today's Date:*

MM/DD/YY

Position Interested In:

CORPORATE OFFICE POSITION APPLYING FOR:
Position	Location	Apply

Inside Sales	St. Joseph
Outside Sales	Kansas City

FIELD POSITION APPLYING FOR:
Position	Location	Apply

Winder	St. Joseph, MO
Field Service Technician	Midwest

Position Location:

The business territory RS Electric Motor Sales & Service functions in is St. Joseph and Kansas City in Missouri and Topeka, Kansas. As the business climate changes the position you are seeking may require some regional travel.

Check all locations where you are willing to work:
St. Joseph, MO
Kansas City, MO
Topeka, KS

How did you learn about employment opportunities with RS Electric Motors?:

Online Job Search Engine – Name:
Staffing Agency – Name:
State Employment Service – Name:
Current Employer – Name:
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Referral – Name:
Other – Name:

Applicant Information

First Name:*

Middle Initial:

Last Name:*

Address:*

City:*

State:*

Zip Code:*

Email Address:*

Primary Phone:*

Secondary Phone:

Are you 18 years of age or older:

Yes No

Are you legally permitted to work in the United States?
(Proof will be required upon employment)

Yes No

Have you ever been convicted of or pled guilty to felony or misdemeanor?:

Yes No

Charge:
Sentence:

Are you related to anyone currently employed at RS Electric Motors?:

Yes No

Name:

Have you ever been employed by RS Electric Motors?:

Yes No

If yes, last date of employment:

Are you currently employed?:

Yes No

If yes, may we contact your present employer?:

Yes No

May we contact your former employers?:

Yes No

On what date would you be available to work?:

Will you work overtime if required?:

Yes No

Will you travel if a job requires it?:

Yes No

If available are you willing to be paid by direct deposit?:

Yes No

Marital Status:

Married Single

Smoker:

Yes No

Work Experience

Most Recent Employer

Name:

Address:

City:

State:

Zip Code:

Phone:

Job Title:

Dates of Service:

From: To:

Hourly Rate/Salary:

Starting: Final:

Did this employer provide health insurance for yourself and dependents?:

Yes No

Job Duties:

Name of Supervisor:

Reason for leaving:

Next Most Recent Employer

Name:

Address:

City:

State:

Zip Code:

Phone:

Job Title:

Dates Of Service:

From: To:

Hourly Rate/Salary:

Starting: Final:

Did this employer provide health insurance for yourself and dependents?:

Yes No

Job Duties:

Name of Supervisor:

Reason for leaving:

Next Most Recent Employer

Name:

Address:

City:

State:

Zip Code:

Phone:

Job Title:

Dates of Service:

From: To:

Hourly Rate/Salary:

Starting: Final:

Did this employer provide health insurance for yourself and dependents?:

Yes No

Job Duties:

Name of Supervisor:

Reason for leaving:

Education & Training

Name of High School:

City:

State:

Did you graduate?:

Yes No

If not, give last grade completed:

If not, did you pass the GED?

Yes No

Name of college:

Did you graduate?:

Yes No

If not, how many years did you attend?:

Certificate/Degree:

Do you hold any professional license(s) or certification(s)?:

Yes No

If yes, describe:

Have you been trained on OSHA 10?

Yes No

If yes, OSHA 10 card #:

Have you been trained on CPR?:

Yes No

Date trained:

In accordance with the Privacy Act, Freedom of Information Act & Fair Credit Reporting Act and in making this application for employment, I understand that an investigative consumer report may be made whereby information is obtained through personal interview with my neighbors, friends, former employers, or others with whom I am acquainted. This inquiry includes information as to my responsibility, character, general reputation, personal characteristics, mode of living, financial and any credit records. I understand that I have a right to make written requests within a reasonable period of time to receive additional, detailed information about the nature and scope of the investigative consumer report. I authorize the persons, organizations or employers to furnish such information and release them from any and all liability for any damage flowing from the issuing of such information. I authorize RS Electric Motor Sales & Service to release to other prospective employers and governmental authorities any information regarding my employment or information asset forth in this application or gained from other companies, schools, or persons named in this application.

RS Electric Motor Sales & Service is an Equal opportunity Employer. Our Employment policy provides that employees will be selected, promoted and assigned without regard to race, color, creed, national origin, age, sex, handicap, disability, or veteran status. It is our objective to provide reasonable accommodation to qualified individuals with a disability. RS Electric Motor Sales & Service frequently works on federal projects that are federally funded and is subject to the Rehabilitation Act of 1973.

I certify that the answers given by me to the foregoing questions are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that any misleading or incorrect statement may render this application void, and if employed, would be a cause for termination whenever discovered. I understand and agree that I will be subject to a drug and alcohol screening & pre-hire physical testing prior to my employment. I also understand that as a condition of continued employment that I will be subject to a drug and alcohol test when reasonable cause exists and/or compliance with a written policy or program. I acknowledge that RS Electric Motor Sales & Service reserves the right to inspect all property, including vehicles, tool boxes, purses, etc. that is on company premises, and if employed, I agree to cooperate with such inspection as a condition of continued employment.

I fully understand, and agree to abide by, that RS Electric Motor Sales & Service has established minimum labor production standards, which must be continually met as a condition of employment. I also agree to abide by the rules and regulations of the company and understand that my employment is for an indefinite time period and that due to business or other consideration, the Company or I may, at the option of either, terminate that employment with or without cause and with or without notice. I understand that no one in the Company, other that in writing by the President, has the authority to enter into any agreement contrary to the foregoing or make any oral assurances or promises of continued employment and this e-application is not an employment contract.

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I Agree:

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