Moore Corporation :: Application for Employment

Applicant Note

This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. If employment is offered, it is strictly on an "at will" basis, which means that you may resign at any time, or Moore Corporation (MOORE) may terminate your employment at any time for no reason, or for any reason not prohibited by law. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of sex, marital status, race, age, creed, national origin or the presence of disabilities. A felony conviction will not necessarily bar an applicant from employment. Affirmative action hiring may be requested by qualified applicants. Additional testing of job-related skills and for the presence of drugs on your body may be required prior to employment. After an offer of employment, and prior to reporting to work, you are required to submit to a medical review. Depending on company policy and the needs of the job, you will be required to complete a medical history form and may be required to be examined by a medical professional designated by the company.

Moore Corporation is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, veteran status, or any other legally protected status.

General Information
Name Social Security
Address Home Phone
City, State, ZIP Code Work Phone
Emergency Contact Phone
Prior Address Have you applied at MOORE before? Yes   No  
Prior City, State, ZIP Who referred you to MOORE?
Availability
Position applied for: Requested Rate of Pay:
Full-Time Part-Time Temporary Date Available to Work:
Education
Level of Education Name of School From
Year
To
Year
Did you graduate? List Degrees
High School Yes No
College Yes No
Graduate School Yes No
Other (Specify) Yes No
Employment
Employer /
Address
Supervisor /
Phone
From Year /
To Year
Position /
Salary
Describe your job responsibilities:
Job Skills

Drivers License Number State of Issue: Is your license currently valid? Yes   No  
Type of License: Endorsements: Restrictions:
Moving violations in the last three years? Do you have other skills, licenses, or certificates that are job-related?
Have you been given a job description, or had the requirements of the job explained to you? Yes   No   Do you understand these requirements? Yes   No  
Can you perform the requirements of this job with or without reasonable accomodation Yes   No    
Security
List all counties and states of residence for the past seven years: County/State (list all):   
Have you used another name or Social Security Number, other than those listed above?
Yes   No 
If so, list all:   
Have you been convicted of a felony and/or served time for a felony within the past seven years?
Yes   No
If so, please give details (incident, location, charge):   
References
Name Address Phone Years
Known
Relationship
Comments
Certification, Release and ADR

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Moore Corporation to verify their accuracy and to obtain reference information on my work performance. I hereby release Moore Corporation from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of Moore Corporation However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at-will and that either I or Moore Corporation may terminate my employment at any time with or without notice or cause.

Digital Signature*   Date*   Email*   © 2012 Moore Corporation