Employment > On-line Application

Qualified applicants for Dealers Supply Company, Inc. will receive consideration for employment without discrimination because of sex, martial status, race, color, creed, national origin, age, or the presence of a disability.   False statements on this online application shall be considered sufficient cause for termination.  The use of this form does not indicate that there are any positions open. 

Personal Information
*Name:
(First, MI, Last)
Other Names Known By:
*Desired Location:
*Position Appling for at Dealers Supply, Inc:
*Home or Message Phone Number: (with area code)
*Other Phone Number: (with area code)
*Present Address:
How Did You Hear About Us? Advertisement
Employment Agency
Walk-In
Relative
Friend
Other
If you heard of us by a relative or friend please list their name here: 
If other, please describe:
*If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes
No
N/A
*Have you ever filed an application with us before? Yes
No
If yes, give date:
*Have you ever been employed with us before?
 Yes
No
If yes, give date:
*Are you currently employed? Yes
No
*May we contact your present employer? Yes
No
N/A
*Are you currently party to any non-competition or trade secret agreement? Yes
No
*Min. Salary Desired:
Please list any other companies in this industry for whom you have ever worked.
*Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof of citizenship or immigration status will be required upon employment) Yes
No
*Are you available to work: Full Time
Part Time - Hrs. Available
Temporary
*List any restrictions for overtime:
*Are you currently on "layoff" status or subject to recall? Yes
No
*Have you ever been convicted of a felony, including suspended, expunged, and/or deferred sentences?  (If yes, explain)
A conviction will not necessarily bar employment, but will be considered within the context of the entire application and position applicable. 

 Yes
No
If yes, please describe:
Are you capable of performing in a reasonable manner, with or without reasonable accommodation, the essential activities involved in the job or occupation for which you have applied? Yes
No

EDUCATION
*Did you graduate from High School or receive a GED? Yes
No
Name of High School and City:
*Did you graduate from a Trade or Business school? Yes
No
N/A

Name of Trade or Business school and City:
*Did you graduate from college? Yes
No
N/A
What was your degree?
Name of College and City:
List any certifications or licenses you hold that may help qualify you for employment:
List any job-related professional or technical organizations to which you belong:

Military Service
Dates:
Branch:
Assignment:
Final Rank:
Honorable Discharge? Yes
No

Skills
Answer those questions that are applicable to the position
On what machines and equipment are you experienced?  (If required by job for which you are applying) Forklift
Hand Truck
Hand Tools
Trucks
Other
If other, please describe:
*Can you type? If yes, list WPM.
*If applying for a driver or outside sales position, do you have any restriction on your driver licenses? Yes
No
N/A
*If applying for a driver or outside sales position, have you had your license suspended. revoked or modified by a court of law? Yes
No
N/A
*If applying for a driver or outside sales position, list all traffic related offenses you plead guilty to within 5 years? Yes
No
N/A
Please list all states for which you hold or have held a driver's license:

Employment History 
(please list all employers and periods of unemployment) 
*Employer Name and Address:
*Dates:
*Position / Title:
*Supervisor:
*Phone Number with area code:
*Salary:
*Bonus / Commission:
*Reason For Leaving:
*Duties:
Employer Name and Address:
Dates:
Position / Title:
Supervisor:
Phone Number with area code:
Salary:
Bonus / Commission:
Reason For Leaving:
Duties:
Employer Name and Address:
Dates:
Position / Title:
Supervisor:
Phone Number with area code:
Salary:
Bonus / Commission:
Reason For Leaving:
Duties:
Employer Name and Address:
Dates:
Position / Title:
Supervisor:
Phone Number with area code:
Salary:
Bonus / Commision:
Reason For Leaving:
Duties:

General Information
*Have you ever been released, discharged, or laid off from any position? Yes
No
If yes, please explain:

Applicant's Statement
*

I certify that the information and answers given by me on this application as well as any other information furnished by me in connection with my application for employment are truthful, accurate and complete to the best of my knowledge, and that, I have withheld nothing that, if disclosed would affect this application unfavorably. 

   I authorize the company and its representatives to make any inquiry or investigation which it may deem desirable of the answers, information, and references given by me, and to secure additional job-related information about me, I authorize my present employer, if any, and each of my prior employers to provide any such information regarding my employment and its termination to the company, I release from liability the company and its representatives for seeking such information, and all other persons, corporations, or organizations for furnishing such information.
   I understand that any misrepresentation, inaccuracy or omission made by me in connection with his application may disqualify me for employment by the company and may subject me to discharge if it is discovered after I have been employed by the company. I ALSO UNDERSTAND THAT, IF HIRED, I WILL BE AN EMPLOYEE-AT-WILL AND WILL BE FREE TO RESIGN AT ANY TIME, AND THAT THE COMPANY WILL LIKEWISE BE FREE TO TERMINATE MY EMPLOYMENT AT ANY TIME, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE. I FURTHER UNDERSTAND THAT NEITHER THIS APPLICATION, NOR ANY OTHER COMMUNICATION FROM THE COMPANY IS INTENDED TO CREATE AN EMPLOYMENT CONTRACT AND THAT NO REPRESENTATIVE OF THE COMPANY HAS THE AUTHORITY TO MAKE ANY ASSURANCES TO THE CONTRARY.
Agree with all statements.
Disagree with statements
*
   In an effort to provide employees with a drug-free workplace, the company has adopted a Drug and Alcohol Awareness and Testing Policy. The policy provides for drug and alcohol testing of employees for cause, testing of employees who are involved in an on-the-job accident resulting in personal injury or property damage, and random drug and alcohol testing under certain circumstances. The policy further provides that all applicants with a conditional offer of employment must successfully pass a drug screening urinalysis test as part of their post-offer, pre-employment examination.
   An applicant whose test is positive for illegal drugs will not be hired and his/her conditional offer of employment will be withdrawn.
   I understand that the company has a policy prohibiting the use, possession or distribution of illegal drugs by its employment applicants and employees. I further understand that the company has adopted post-offer, pre-employment drug testing as one method of implementing that policy. I hereby consent to provide a urine sample to the company or its agents to be tested for drugs by a drug testing laboratory designated by the company.
   I hereby authorize any drug testing laboratory designated by the company to release to the company any information requested on any urine sample I submit. This includes, but is not limited to, the results of any tests performed on my urine samples. I hereby authorize the company to use and disclose this information for any purpose connected with my employment application or with the company’s Drug and Alcohol Awareness and Testing Policy, including but not limited to decisions on whether to employ me.
Agree with all statements.
Disagree with statements
*
If I am offered employment, I will, as a condition of employment, be required to produce sufficient documentation of my identity and right to work in the United States and to attest under penalty of perjury that the documents I have produced are genuine and relate to me pursuant to the Immigration Reform and Control Act of 1986. I understand that any false statement, misrepresentation, or omission of facts on this application or on any supporting documents, regardless of when discovered, will result in my immediate dismissal or removal of my application from consideration for employment. I certify that the information I have provided in this application is true and complete. I understand that I will be required to possess a current and valid driver’s license if my job requires me to drive in the course of my work. I understand and agree that, if I am offered a position, it will be offered on condition that my employment shall be at will and for no definite period, and may be terminated by the company or myself at any time with or without cause and with or without prior notice. Nothing contained in any Policy and Procedure Manual, Employee Handbook, or other company document or communication shall be construed to alter or be inconsistent with this paragraph or to limit the company’s employment rights as set forth in Section 2922 “Termination At Will” of the State of Georgia Labor Code. I understand that no supervisor or manager may alter or amend the above conditions except in writing as follows. No agreement for employment which differs from or is inconsistent with this paragraph shall be valid or enforceable unless in writing and signed by either the President of the company or the Vice President responsible for my department. If I am offered employment, I may, as a condition of employment be required to submit to and successfully complete and pass a physical examination. I further understand and agree that any employment regulated by the United States Department of Transportation is conditioned upon submission to and successful completion and passing of pre-employment, random, and for-cause screening for alcohol and illegal drugs/substances. I authorize investigation of all statements contained in this application and any supporting documents. I authorize the company to secure information about my experience from former employers, educational institutions, government agencies, or any references I have provided, and for those parties to provide information concerning my experience and I hereby release all parties from any liability arising in relation to such investigation.
 Agree with all statements.
Disagree with statements
Signature of Applicant:
Date:

82 Kennedy Dr. Forest Park, GA 30297       Tel 404-361-6800       Fax 404-361-2852