< Back to Employment
S. R. PERROTT, INC.
1280 N. U.S. Highway 1
Ormond Beach, FL 32176
APPLICATION FOR EMPLOYMENT
How Long Have You Lived At Your Present Address?
If Less than 3 Years, List All Previous Addresses Below
Are you legally eligible for permanent employment in the United States? (If hired, law will require verification)
Are you 18 or older?
Position Applied For:
OFF-PREMISE SALES DEPARTMENT
DRAFT DELIVERY DRIVER
Rate of pay expected:
How did you hear about this opening?
Have you worked for us before?
If yes, when?
Indicate special qualifications or skills
Operators / CDL: There is a cost for our CDL Training Course if you need to upgrade your license class
Did You Graduate High School?
Course of Study
Did You Graduate College?
Course of Study
Name to Put on Shirt
Employer 1 (*REQUIRED)
Additional Driving Experience
The above information is true and complete to the best of my knowledge. Should the Company employ me, and misrepresentations or false statement contained herein may be considered cause for possible dismissal. The Company has my permission to obtain all necessary information from the references I have listed, or any other sources concerning my prior employment, personal history or credit standing and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice to me. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to the Company.
I understand this application does not constitute an employment contract of any kind. Should the Company employ me, I may resign such employment at any time at my discretion with or without prior notice and the Company may terminate my employment at any time at their discretion, with or without prior notice.
If a job position is offered, I realize I must submit to and pass a pre-employment physical and urinalysis drug screen for my employment to continue, the cost of which will be deducted from my medical reimbursement account when I become eligible for it. I further acknowledge that should my employment end prior to the eligibility for my medical reimbursement benefits, either voluntarily or involuntarily, the cost of my pre-employment testing will be deducted from my final paycheck.
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. Misrepresentation on my physical exam will be grounds for dismissal.
Max file size 10MB.
Upload failed. Max size for files is 10 MB.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.