Employment Application

* Position Applying For

* Date of Application

Equal Employment Opportunity (EEO) Statement

Medical Waste Services is an Equal Opportunity Employer. We are committed to creating a diverse environment and are proud to be an equal opportunity workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Personal Information

* Full Name

* Phone

* Email

* Address

* City

* State

* Zip

Are you legally authorized to work in the U.S.?

Yes No

Are you 18 years or older?

Yes No

Do you have a valid driver's license?

Yes No

Employment Desired

Date Available

Employment Type

Have you ever worked for this company before?

Yes No

High School

School Name

Location

Degree/Certificate

Years Attended

Graduate?

Yes No

College/University

School Name

Location

Degree/Certificate

Years Attended

Graduate?

Yes No

Other Education

School Name

Location

Degree/Certificate

Years Attended

Graduate?

Yes No

Most Recent Employer

* Employer Name

* Address

* Phone

* Supervisor

* Job Title

* Dates Employed

* Reason for Leaving

Previous Employer

Employer Name

Address

Phone

Supervisor

Job Title

Dates Employed

Reason for Leaving

Reference 1

* Name

* Phone

* Relationship

* Title

Reference 2

* Name

* Phone

* Relationship

* Title

Special Skills & Qualifications

Special Skills & Qualifications

Background & Driving History

Have you ever been convicted of a felony?

Yes No

Do you have any current moving violations or restrictions?

Yes No

In accordance with 49 CFR Parts 391 and 382, if you are applying for a position that requires operating a vehicle that meets DOT guidelines (GVWR over 10,001 lbs or transporting regulated medical waste), you may be subject to:

Pre-employment drug testing
DOT physical examination and medical certification
Participation in random drug and alcohol testing
Inquiry into past drug and alcohol test results from previous DOT-regulated employers

By signing below, you authorize [Your Company Name] to request and receive information required by the DOT from former employers and medical examiners, and to conduct required background and driving record checks.

Applicant Statement

I certify that the answers provided in this application are true and complete to the best of my knowledge. I understand that any false or misleading information may result in my disqualification from employment or termination if already employed. I authorize the investigation of all statements in this application and release all parties from liability for any damage that may result from furnishing this information. I understand that this application is not a contract of employment.

* Applicant Signature

* Date

Medical Waste Services sets the industry standard by handling biohazard waste entirely in-house, transporting and treating it without outsourcing, this ensures customer compliance. Let us take care of your medical waste needs.

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