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Employment Application

Employee Information



































 No Yes



 No Yes



 No Yes



 No Yes


Employment History


 Yes No





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Employer #1














Employer #2














Employer #3















With the submission of this "online" application, it is agreed and understood that any
misrepresentation given shall be considered an act of dishonesty.

It is also agreed and understood that Brothers Express, Inc., or any of it's agents may
investigate the application's background to ascertain any and all information of concern to
the applicant's record, whether same is of record or not, and applicant releases employers
and persons named herein from liability for any damages on account of his/her furnishing
such information.

If is understood that under the Fair Credit Reporting Act, Public Law 91-508, I am aware that any investigation may include an Investigating Consumer Report, a state Motor Vehicle
Report, including information regarding my character, general reputation, driving record,
personal characteristics, criminal history, and mode of living.

I also agree to furnish such information and complete any examinations as may be requiredto complete my employment file.

It is further agreed and understood that this "online" application for qualification in no wayobligates Brothers Express, Inc. to employ me.

With this application submission, I attest to the best of my knowledge, that the information I have provided is accurate and true.

I have read, understand, and agree to the above terms.