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Application for Employment
First Name
Last Name
Country
Address Line 1
City
State
Postal Code
If yes, please list, including: Class of equipment, Type of Equipment (Van, Tank, Flat, Etc.), Dates (From and To), and approx miles driven.

Employment History

DOT requires that employment for at least 3 years and/or commercial driving experience for the past 10 years be shown

Employer 1

Country
Address Line 1
City
State
Postal Code

Employer 2

Country
Address Line 1
City
State
Postal Code

Employer 3

Country
Address Line 1
City
State
Postal Code

Education

Acknowledgement & Understanding

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. Uribe Refuse Services, Inc. is hereby authorized to make any investigations of my prior educational and employment history. I understand that employment at Uribe Refuse Services, Inc. is “at will,” which means that either I or Uribe Refuse Services, Inc. can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis.
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    A 1st
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