Personal Information

Employment Information

Are you currently employed?
Yes No
If so, may we contact your current employer?
Yes No
Have you ever applied to Superior before?
Yes No

Education

Graduate?
Yes No
Degree?
Yes No
Graduate?
Yes No
Graduate?
Yes No

Job Related Skills:

Note: DO NOT complete any part you believe to be non-job related.
Do you fluently speak any other non-English language?
Yes No
If the job requires, do you have the appropriate valid driver's license?
Yes No
Have you had any moving violations?
Yes No
Have you ever been enlisted in the U.S. Military or Naval Service?
Yes No

References

(Include only individuals familiar with your work ability. No relatives)

Employment History

Most recent Employer
May we contact this employer?
Yes No
to
Second Most recent Employer
May we contact this employer?
Yes No
to
Third Most recent Employer
May we contact this employer?
Yes No
to

Additional Comments

Optional Information

Security

Certification and Release

Please read the following and check "I Agree" below.
I certify that I have read and understand this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any of this information. I authorize all former employers, persons, schools, companies, and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.
Yes I Agree I do not agree