Application For Employment

We consider applications for all positions without regard to race, color, religion, creed, sex, national origin, disability, sexual orientation, citizenship status or any other legally protected status.


Are you prevented from lawfully becoming employed in the United States?
(Proof of citizenship or immigration status will be required upon employment)

Are you 18 years of age or older?

Have you ever submitted an application here before?

Have you ever been employed here before?

If yes, give date(s):

Is this application a request for re-employment following an extended military leave of absence from this company?

Do any of your friends or relatives, other than spouse, work here?

Are you currently employed?

May we contact your current employer?

Are you able to perform the “essential functions” of the job for which you are applying (either with or without a reasonable accommodation):

Desired salary range or hourly rate of pay:

Type of employment desired:

Are you currently on "lay-off" status and subject to recall?

Will you travel if job requires it?

If they have been explained to you, are you able to meet the attendance requirements of the position?

Are you available to work overtime?

Are you available to work nights?

Do you have a driver's license?
(If yes, a copy will be required upon employment)

Have you had any accidents during the past three years?

Have you had any moving violations during the past three years?

Have you ever been in the armed forces?

Are you now a member of the National Guard?




Bus./Trade School

Professional School

Do you have a current DOT medical card?

Do you have OSHA Certifications?

If yes, fill out relevant fields below:

40 Hour OSHA 49 CFR 1910.120 Training

8 Hour OSHA Refresher

OSHA Confined Space Entry Training

OSHA Confined Space Rescue Training

Other OSHA Training

Other OSHA Training



Job 1

Job 2

Job 3



Reference #1

Reference #2

Reference #3


  • I certify that all information I have provided in order to apply for and secure work with Ziron Environmental Services is true, complete, and correct.
  • I expressly authorize, without reservation, Ziron Environmental Services, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview.
  • I release Ziron Environmental Services, its employees, representatives and agents from any claims or liability relating to information provided to Ziron Environmental Services as part of the application process. I also hereby waive any and all rights and claims I may have regarding Ziron Environmental Services, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.
  • I understand that Ziron Environmental Services does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or federal law.
  • I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard fro m Ziron Environmental Services and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.
  • If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and Ziron Environmental Services reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of Ziron Environmental Services is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the Ziron Environmental Services’ president. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
  • Ziron Environmental Services does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her sex, race, color, religion, n ational origin, citizenship, age, disability, or any other protected status under applicable federal, state, or local law. Ziron Environmental Services likewise does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status. Examples of prohibited harassment include, but are not limited to, unwelcome physical contact, offensive gestures, unwelcome comments, jokes, epithets, threats, insults, name-callling, negative stereotyping, possession or display of derogatory pictures or other graphic materials, and any other words or conduct that demean, stigmatize, intimidate, or single out a person because of his/her membership in a protected category. Harassment of our employees is strictly prohibited, whether it is committed by a manager, coworker, subordinate, or non-employee (such as a vendor or customer). Ziron Environmental Services takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly.
  • I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to eliminate me from further consideration of employment or may result in my immediate discharge from the employer’s service, whenever it is discovered.
  • I have read, and agree to the Authorization And Consent For Background Check form and have also read the corresponding FCRP Notice.


I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.