H Cox & Son Job Application Question Title * 1. Please enter your full name: Question Title * 2. Enter your home address: Question Title * 3. Enter your phone number: Question Title * 4. Enter your email address: Question Title * 5. If hired, what date are you available to begin work? Date Date Question Title * 6. What position are you applying for? Question Title * 7. What is your availability to work? Full Time Part Time Second Shift (10AM - orders are finished, varies based on season) Question Title * 8. What is your desired salary range? Question Title * 9. Have you ever submitted an application to H Cox before? Yes No Question Title * 10. Are you a citizen of the United States? If not, are you authorized to work in the United States? Yes, I am a citizen of the US. No, I am not a citizen of the US, but I am authorized to work in the US. No, I am not a citizen of the US, and I am not authorized to work in the US. Question Title * 11. Have you ever been convicted of a felony? If yes, please provide detail. Question Title * 12. Please attach your resume if it is available. Question Title * 13. If you do not have a resume available, please include information on your education (high school, college, etc name and if you graduated) below. Question Title * 14. If you do not have a resume available, include information on your prior work experience (company name, job title, approximate dates of employment, reason for leaving, salary) below. Question Title * 15. CDL position only - Under your prior employment, were you subject to the Federal Motor Carrier Safety Regulations? Yes No Question Title * 16. CDL position only - Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40? Yes No Question Title * 17. CDL positions only - Have you had a positive drug test or refused a drug test in the past 3 years? Yes No Question Title * 18. Describe any other qualifications or specialized training that may apply to this position. Question Title * 19. Do you certify that your answers are true and complete to the best of your knowledge? Do you understand that if this application leads to employment, false or misleading information in your application or interview may result in your termination? Yes No Done
