PFI RUBBISH SERVICE - EMPLOYMENT APPLICATION
Applications are considered for all positions without regard to race, color, religion, sex, national origin, age,
marital or veteran status, or non-related medical condition or handicap.
Full Name________________________________________________________Date_________________
Address___________________________________________________Phone #___________________
City_____________________State_____Zip__________Social Security #_______________________
DOB_________________Are you a citizen of the United States of America? [ ] Yes [ ] No
Have you applied here before? [ ] Yes [ ] No When?______Position applied for?_________________
Start When_______________ [ ] Full time [ ] Part time [ ] Temporary [ ] Other__________________
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EMPLOYMENT EXPERIENCE Start with your present job or last job. Include military assignments and other
volunteer activities. Exclude organizational names which indicate race, color, religion, sex, or national origin
Employer 1__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors’ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate______________________
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Employer 2__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors’ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate_____________________
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Employer 3__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors’ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate______________________
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EDUCATION
Schools/Collages Attended: # Years Year Grad. Degree
____________________________________________________ _______ _______ ___________
____________________________________________________ _______ _______ ___________
____________________________________________________ _______ _______ ___________
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Describe any special qualifications for this job:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
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Drivers License #_______________________________State__________Expiration_______________
Class [ ] 1 [ ] 2 [ ] 3 [ ] 4
Do you have a clean driving abstract? [ ] Yes [ ] No (A copy of your abstract may be included with application.)
Do you have a CDL License? [ ] Yes [ ] No If yes, Class [ ] A [ ] B [ ] C [ ] H [ ] T [ ] P [ ] N [ ] X
Can you pass a drug test? [ ] Yes [ ] No
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I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize
investigations of all statements contained in this application for employment as may be necessary in arriving
at an employment decision. I understand that this application is not intended to be a contract of employment.
In the event of employment, I understand that false or misleading information given on my application or
interview may result in termination.
Signature___________________________________________________Date_____________________
Please print out and mail completed application to:
PFI RUBBISH SERVICE INC
74-5599 PAWAI PLACE
KAILUA-KONA, HI 96740
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For Personnel Department only
Remarks____________________________________________________________________________
___________________________________________________________________________________
__________________________________________Interview report by__________________________
