DRIVER'S APPLICATION FOR EMPLOYMENT Address*
Investigations Consent* TO BE READ AND SIGNED BY APPLICANT I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand I have the right to:
Review information provided by previous employers; Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. I Understand*
APPLICANT TO COMPLETE (answer all questions - please print)
Name*
First
Middle
Last
List your addresses of residency for the past 3 years. Current Address*
Previous Address #1
Previous Address #2
Do you have the legal right to work in the United States?* Have you worked for this company before?* Date From*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
Date To*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
Are you now employed?* If yes, please explain fully on a seperate sheet of paper. Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.
If yes, explain if you wish.
EMPLOYMENT HISTORY All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceeding 3 years. List complete mailing address, street number, city, state, and zip code.
Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an
additional 7 years' information on those employers for whom the applicant operated such vehicle.
(NOTE: List employers in reverse order starting with the most recent.)
Beginning with most recent, list below all current & past employment for a minimum of 15 years.
EMPLOYER #1 ADDRESS*
DATE FROM*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
WERE YOU SUBJECT TO THE FMCSRs†WHILE EMPLOYED?* WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTION IN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG AND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?*
EMPLOYER #2 ADDRESS*
DATE FROM*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
WERE YOU SUBJECT TO THE FMCSRs†WHILE EMPLOYED?* WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTION IN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG AND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?*
EMPLOYER #3 ADDRESS
DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
WERE YOU SUBJECT TO THE FMCSRs†WHILE EMPLOYED? WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTION IN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG AND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?
EMPLOYER #4 ADDRESS
DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
WERE YOU SUBJECT TO THE FMCSRs†WHILE EMPLOYED? WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTION IN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG AND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?
EMPLOYER #5 ADDRESS
DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
WERE YOU SUBJECT TO THE FMCSRs†WHILE EMPLOYED? WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTION IN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG AND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40? ACCIDENT RECORD FOR PAST 3 YEARS OR MORE. IF NONE, CHECK NONE  BELOW
No Accident Record
LAST ACCIDENT
NEXT PREVIOUS #1
NEXT PREVIOUS #2
NEXT PREVIOUS #3
NEXT PREVIOUS #4
NEXT PREVIOUS #5 TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) IF NONE, WRITE NONE
No Traffic Convictions and Forfeitures DRIVER LICENSES LIST ALL DRIVERS LICENSES AND/OR PERMITS HELD IN PAST 3 YEARS
A. Have you ever been denied a license, permit, or privilege to operate a motor vehicle? B. Has any license, permit, or privilege ever been suspended or revoked? IF THE ANSWER TO EITHER A OR B IS YES, GIVE DETAILS
DRIVING EXPERIENCE
CLASS OF EQUIPMENT STRAIGHT TRUCK SELECT TYPE OF EQUIPMENT DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
TRACTOR AND SEMI-TRAILER SELECT TYPE OF EQUIPMENT DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
TRACTOR - TWO TRAILERS SELECT TYPE OF EQUIPMENT DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
TRACTOR - THREE TRAILERS SELECT TYPE OF EQUIPMENT DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
MOTORCOACH - SCHOOL BUS More than 15 passengers
DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
MOTORCOACH - SCHOOL BUS More than 15 passengers
DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE FROM
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
DATE TO
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
LIST STATES OPERATED IN FOR THE LAST FIVE YEARS:
SHOW SPECIAL COURSES OR TRAINING THAT WILL HELP YOU AS A DRIVER:
WHICH SAFE DRIVING AWARDS DO YOU HOLD AND FROM WHOM?
EXPERIENCE AND QUALIFICATIONS - OTHER SHOW ANY TRUCKING, TRANSPORTATION OR OTHER EXPERIENCE THAT MAY HELP IN YOUR WORK FOR THIS COMPANY
LIST COURSES AND TRAINING OTHER THAN SHOWN ELSEWHERE IN THIS APPLICATION
LIST SPECIAL EQUIPMENT OR TECHNICAL MATERIALS YOU CAN WORK WITH (OTHER THAN THOSE ALREADY SHOWN)
EDUCATION SELECT HIGHEST GRADE COMPLETED HIGH SCHOOL COLLEGE
LAST SCHOOL ATTENDED
TO BE READ AND SIGNED BY APPLICANT Motor Vehicle Driver's CERTIFICATION OF COMPLIANCE WITH DRIVER LICENSE REQUIREMENTS
MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver who operates in intrastate, interstate, or foreign commerce and operates a vehicle weighing 26,001 pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding.
The requirements in Part 391 apply to every driver who operates in interstate commerce and operates a vehicle weighing 10,001 pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding.
DRIVER REQUIREMENTS: Parts 383 and 391 of the Federal Motor Carrier Safety
1) POSSESS ONLY ONE LICENSE: You, as a commerical vehicle driver, may not
2) NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION: Sections 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation or suspension of your driver's license. In addition, Section 383.31 requires that any time you violate a state or local traffic law (other than parking), you must report it within 30 days to: 1) your employing motor carrier, and 2) the state that issued your license (If the violation occurs in a state other than the one which issued your license). The notification to both the employer and the state must be in writing.
The following license is the only one I will possess:
DRIVER CERTIFICATION* I certify that I have read and understood the above requirements.
Notes
(This form is not required for DOT compliance)
PREVIOUS PRE-EMPLOYMENT EMPLOYEE ALCOHOL AND DRUG TEST STATEMENT Per SEC. 40.25(j) we, as the employer, must ask applicants if they have tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which the employee applied for, but
did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the
past two years. If the employee admits that he or she had a positive test or a refusal to test, you must not use the
employee to perform safety-sensitive functions for you, until and unless the employee documents successful
completion of the return-to-duty process. (see Sec. 40.25(b)(5) and (e))
As a prospective employee, you are required by Sec. 40.25(j) To answer the following questions:
Drug and alcohol testing?* 1) Have you tested positive, or refused to test, on any pre-employment drug or alcohol test
administered by an employer to which you applied for, but did not obtain, safety-
sensitive transportation work covered by DOT agency drug and alcohol testing rules
during the past two years?
Return to duty requirements?* 2) If you answered yes, can you provide/obtain proof that you've successfully completed the DOT return-to-duty requirements?
I certify that the information provided on this document is true and correct.
Prospective Employee Signature* WITNESSED BY (SIGNED BY JOY CONE)
REQUEST FOR CHECK OF DRIVING RECORD I hereby authorize you to release the following information to Joy Cone
In accordance with the provisions of Sections 604 and 607 of the Fair Credit Reporting Act , Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter 1 of Public Law 104-208), I hereby certify the following:
The consumer (applicant) has authorized in writing the procurement of this report;
The consumer (applicant) has been informed in a separate written disclosure that a consumer report may be obtained for employment purposes;
The information requested below will be used for a "permissible purpose" (i.e. information for employment purposes) and will be used for no other purpose;
The information being obtained will not be used in violation of any federal or state equal opportunity law or regulation; and
Before taking an adverse action based in whole or in part on the report the consumer (applicant) will receive a copy of the requested report and the summary of consumer rights as provided with the report by the consumer reporting agency.
I also hereby certify that this report request and the above applicant's release notice meet the definition of "permissible uses" of state motor vehicle records under the provisions of the Driver's Privacy Protection Act of 1994 (Public Law 103-322, Title XXX, Sections 300002(a)).
ADDRESS*
FORMER ADDRESS*
REQUESTED BY Address*
Request for Driver Information The following states do not require the use of a state-specific form to obtain an individual's driving record. This information is current through May 6, 2004, and is subject to change
THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS IMPORTANT DISCLOSURE
In connection with your application for employment with Joy Cone Co.
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.
When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.
Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.
The Prospective Employer cannot obtain background reports from FMCSA without your authorization.
AUTHORIZATION
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:
I authorize Joy Cone Co.
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.
I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear
on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.
NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant’s consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language
SAFETY PERFORMANCE HISTORY RECORDS REQUEST TO BE COMPLETED BY PROSPECTIVE EMPLOYEE
Name*
First
Middle
Last
Present Address*
Previous Address*
Preferred method of contact*
JOY CONE CO. BENEFITS PACKAGE JOY CONE COMPANY IS NOT A MINIMUM WAGE COMPANY . By offering a wage scale that is relatively high within the local job market, we expect to attract and retain correspondingly high quality employees in terms of dedication and conscientious work habits. Joy Cone Company is 100% employee owned and operated, and is one of the most efficient and productive companies in the industry. It is this productivity and the quality of our employees that has allowed us to provide an excellent wage and benefits package.
* For full time and part time employees we provide the following:
1) Medical, eye and dental
6) Profit sharing
2) Bonus program
7) Flexible scheduling
3) Vacation pay
8) Life insurance
4) Holiday pay
9) 401(k) with generous company match
5) Sick pay
* “CASUAL” and “TEMPORARY” employees are eligible for limited holiday pay and bonuses.
NOTICE TO APPLICANTS:
Please do not phone Joy Cone regarding the status of your application.
We will not answer phone inquiries concerning your application.
Consent for incomplete info* Applications will be rejected due to incomplete information . (However, if you do not understand something or have a question about what is required in this application, call the Human Resources department for clarification or attach a note explaining your concern.)
I understand*
Any false statement made on this application or any other employment related document is grounds for rejection or termination. Employment is ‘AT WILL’.
Consent for any false statement* Any false statement made on this application or any other employment related document is grounds for rejection, rescinding of any offer, or termination. Employment is ‘AT WILL’.
I understand*
NOTICE TO APPLICANTS UNDER 18 YEARS OF AGE: Joy Cone Co. is required by PA state law to have on file working papers for any employee under 18 who has not graduated from high school. Applicants under 18, if hired, must obtain working papers from their high school before they can be put on the work schedule. If you are hired, you will be required to show proof of age.
Joy Cone Company is an Equal Opportunity Employer Experience* Are there any experiences, skills, or qualifications which you feel would especially qualify you for work with our organization?
Please list the names of any relative(s) and/or friend(s) currently employed by JOY CONE COMPANY. You may also list any of your friends who currently work at Joy Cone as a personal reference later in this application process.
How did you hear of Joy Cone Co.?* Friend/Relative Newspaper advertisement Radio advertisement Website or Job Board Job Fair Other
Refer to Full Time/Part Time/Casual/Temp requirements on page 8.
NOTE: High school students are hired as either casual or temporary. Note: Full time packers may have to start at part time.
I am applying for year round employment* I am applying for temporary/seasonal employment* Have you previously applied to JOY CONE?* Were you ever employed by JOY CONE CO.?*
Work Eligibility* Are you legally eligible to work in the United States? (Proof of citizenship or work eligibility status will be required upon employment.)
Any legal charges?* Have you ever (without time limit) been convicted, have or had pending charges, pled guilty or NOLO CONTENDERE (no contest), or are currently awaiting trial on any legal charges other than traffic violations? (DUI’s, and/or substance abuse must be reported.)
If yes, please provide date(s) and details:*
Note: Prior convictions do NOT automatically disqualify an application however we routinely do criminal background checks per company policy. Any intentional misrepresentation on this application will most likely result in immediate termination or retraction of a job offer.
Employment History MAY WE CONTACT YOUR CURRENT EMPLOYER?* BEGINNING WITH MOST RECENT , LIST BELOW ALL CURRENT & PAST EMPLOYMENT. You must state each employer's complete address , including zip code and phone number, or yourmay not be processed.
All applicants must complete this page in full. First Job? Check here if this is your first job.
Address*
Employed from (month & year)*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Employed to (month & year)*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Reason for leaving (describe in full):*
If there is more than a two-month employment gap, please provide details:
Additional Experience #2 Add additional Experience #2
Address #2*
Employed From (month & year) #2*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Employed to (month & year) #2*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Reason for leaving (describe in full) #2*
If there is more than a two-month employment gap, please provide details #2
Additional Experience #3 Add additional Experience #3
Address #3*
Employed From (month & year) #3*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Employed to (month & year) #3*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Reason for leaving (describe in full) #3*
If there is more than a two-month employment gap, please provide details #3
Additional Experience #4 Add additional Experience #4
Address #4*
Employed From (month & year) #4*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Employed to (month & year) #4*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Reason for leaving (describe in full) #4*
If there is more than a two-month employment gap, please provide details #4
Additional Experience #5 Add additional Experience #5
Address #5*
Employed From (month & year) #5*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Employed to (month & year) #5*
Year 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980
Month
Reason for leaving (describe in full) #5*
If there is more than a two-month employment gap, please provide details #5
AUTHORIZATION TO RELEASE SCHOOL, EMPLOYMENT, AND MILITARY RECORDS I am applying for employment at JOY CONE CO. I hereby request you provide them with all my cumulative records including grades, test scores, transcripts, attendance, and any relevant information and opinion that you may have concerning my high school, college, employment or military experience. I release you and your organization from any legal liability in making such statements. This information will be treated in a strictly confidential manner.
Under Age I am under 18 years of age
Parent/Guardian’s Signature* This info is necessary to obtain high school &/or college transcripts. Please print clearly and complete in full:
Applicant's Name*
(First)
(Middle)
(Last)
Are you in or have you completed high school?* Are you in or have you completed college?*
Graduated?* What year?*
Year 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Month
Expected Graduation Date*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
Other Schooling or Training
Graduated?* What year?*
Year 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Month
Expected Graduation Date*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
Graduated?* What year?*
Year 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
Month
Expected Graduation Date*
Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982
Month
Did you serve in the military?* What Branch?* Air Force Army Coast Guard Marines Navy Space Force
List duties/special training
PERSONAL REFERENCES (Not former Joy Cone employees or relatives)
PLEASE COMPLETE IN FULL OR YOUR APPLICATION CANNOT BE PROCESSED Joy Cone Co. is an equal opportunity employer and Joy Cone will make reasonable accommodations for applicants and qualified individuals with disabilities.
The facts set forth in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal.
I understand that this application does not, by itself, create a contract of my employment. I understand and agree that, if hired, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD OF TIME, and may, regardless of the date of payment of my wages or salary, BE TERMINATED AT ANY TIME. If hired, I will be issued an employee handbook that will explain in detail all company policies. It will be my responsibility to read the handbook and discuss any questions with management. I understand that NO PERSON IS AUTHORIZED TO CHANGE ANY OF THE TERMS MENTIONED IN THIS EMPLOYMENT APPLICATION FORM.
Under Age 2 I am under 18 years of age
Parent/Guardian’s Signature* (If applicant is under 18)
TOBACCO/NICOTINE POLICY Joy Cone gives strong hiring preference to non-tobacco users.
Do you use any tobacco products?* Note: A nicotine test is included in the pre employment physical exam. Misrepresentation on this application is grounds for retraction of any job offer.
ABSENTEEISM
This is to advise you beforehand, that JOY CONE CO. has a very strict attendance policy. We require good attendance from all employees.
(Complete attendance policy is available in the employee handbook.)
Tobacco Consent* DISCLOSURE AND CONSENT: may utilize the services of a reporting agency to provide a report(s) of background information bearing on my credit, character, general reputation, personal characteristics or mode of living. I understand that this information may include, but is not limited to, the following types of information: credit reports, prior employment history, education, criminal record, driving record, judgments, liens, bankruptcies, drug test results, etc.
I hereby consent to the above Disclosure and Consent and authorize JOY CONE CO. to procure a report(s) as stated above from a reporting agency. This authorization shall remain on file and shall serve as ongoing authorization for JOY CONE CO. to procure such reports at any time during my employment with JOY CONE CO.
I understand*
Under Age 3 I am under 18 years of age
Parent/Guardian’s Signature* (If applicant is under 18)
* PACKER SUPPLEMENT * FOR PACKER APPLICANTS ONLY Applicants for all other positions may leave this page blank
Packers must be able to work rotating shifts on a continuous seven day schedule.
FULL-TIME:
DAY TURN - 7am to 3pm AFTERNOON TURN - 3pm to 11pm MIDNIGHT TURN - 11pm to 7am
Note: We do have some steady afternoon & midnight turns whenever there are open slots.
PART-TIME: 7am to 11am/12pm * 10am/11am to 3pm * 3pm to 7pm/8pm * 6pm/7pm to 11pm
Note: We do offer a steady 6pm to 11pm and a steady part-time midnight (11pm to 7am, 3nights/week) shift. These steady shifts are granted when there are open slots.
CASUAL you must be available to work most weekends (defined as beginning at 3pm on Friday and lasting through 11pm Sunday.) On weekdays , you will be scheduled according to your request. However, this means that if we cannot fit your requested schedule into our production schedule, YOU WILL NOT BE SCHEDULED. Casual employment status is ideal if you are a high school or college student, or for those who have other part-time commitments. HIGH SCHOOL STUDENTS WILL NOT BE SCHEDULED ON THE 7-11PM SHIFT IF THEY HAVE SCHOOL THE FOLLOWING DAY.
TEMPORARY
PACKER JOB DESCRIPTION - PACKING CONES IS AN EXTREMELY PHYSICALLY DEMANDING JOB. Packers are required to stand on their feet between 5 & 8 hours per day. Packing cones requires constant bending, turning, twisting & lifting. Constant movement of fingers, hands, wrists & arms at a fast pace is required. Even though we have an evaporative process cooler, it can get hot (80-85 degrees) in the production areas during the summertime.
I have read the above carefully and by my signature, I am stating that I am able to comply
with the above requirements, with or without reasonable accommodation. I understand the
scheduling requirements of the status for which I am applying.
Under Age 4 I am under 18 years of age
Parent/Guardian’s Signature* (If applicant is under 18)
