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EMPLOYMENT

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Capital City Services, Co.

5404 Sandy Valley Road

Mechanicsville, VA 23111

Phone: (804) 746-9665 Fax: (804) 730-1032

Email: info@capitalcityservices.com

SWAM/DBE# 010252 Cont. License# VA2701037331-A VDOT#N1066

ALL POTENTIAL EMPLOYEES ARE EVALUATED WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN, AGE, MARITAL OR VETERAN STATUS, THE PRESENCE OF A NON-JOB RELATED HANDICAP OR ANY OTHER LEGALLY PROTECTED STATUS.

On what day would you be available to start work?
Are you otherwise authorized to work in the U.S. without any restrictions?
Yes
No
Have you ever been convicted of a felony?
Yes
No
Have you ever worked for this company?
Yes
No
Have you ever been involuntarily terminated or asked to resign from any position of employment?
Yes
No

Employment History (Most Recent First)

Employer #1

Start Date
End Date

Employer #2

Start Date
End Date

Employer #3

Start Date
End Date

Education

Did you graduate?
Yes
oNo

ACKNOWLEDGMENT AND AUTHORIZATION 

I certify that answers given herein are true and complete to the best of my knowledge. 

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize any person, educational institution, or company I have listed as a reference on my employment application to disclose in good faith any information they may have regarding my qualifications and fitness for employment. I will hold Capital City Services, Co., any former employers, educational institutions, and any other persons giving references free of liability for the exchange of this information and any other reasonable and necessary information incident to the employment process. 

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. 

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. 

In the event of employment, I understand that false or misleading information given in my application 

or interview(s) 

Date of Application
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