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Application for Employment The Hignell Companies
1750 Humboldt Road - Chico, CA 95928
Phone (530) 894-0404 - Fax (530) 894-6984
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

Position Applied For Desired Salary Date of Application
A post-offer drug screen and physical will be required for all positions prior to working.
If you are applying for a cleaning or painting position, you may need to drive from job to job. Will you have a vehicle for work every day?    Yes    No
Can you provide required proof of insurance for this vehicle?    Yes    No
If you are applying for a position that requires you to drive a company vehicle, it will be necessary to check your driving record with the Department of Motor Vehicles prior to employment to comply with insurance requirements.
Do you have a current California Drivers' License?    Yes    No

How did you learn about us:
 Advertisement  Friend  Walk-in  Relative  Other 

Last Name First Name Middle Name
Address City Zip Code
Telephone Email Address

If you are under 18 years of age, can you provide required proof of your eligibility to work?  Yes    No
Have you ever filed an application with us before?   If Yes, give approximate date:  Yes    No
Have you ever been employed with us before?   If Yes, give dates:  Yes    No
Are you currently employed?  Yes    No
May we contact your present employer?  Yes    No
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
On what date would you be available for work?
Are you available to work:     Full Time  Part Time  Shift Work
Have you been convicted of a felony within the last 7 years?
Conviction will not necessarily disqualify an applicant from employment.
 Yes    No
If Yes, please explain: 

Education
  Name and Address
of School
Course of Study Years
Completed
Diploma
Degree
High
School
Undergraduate
College
Graduate
Professional
Other

Describe any specialized job related training, apprenticeship, skills and extra-curricular activities.
(Including training received in the US Military.)

Summarize special job-related skills and qualifications acquired from employment or other experience.

List Professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

Specialized Skills - Check skills/equipment operated
  •  Personal Computer
    •  IBM    MAC    Other 

  •  Computer Software
    •  Word    Excel    Other 
    •  Access    Pagemaker   Other 
    •  Windows 98 or XP   Other 
  •   Typing WPM 
  •   Ten Key SPM 
  •   Multi-line Phone  # of incoming lines
  • Machinery: (Please list)

Employment Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer:  Dates Employed Work Performed
From To
Address: 
Telephone Number:  Hourly Rate/Salary
Starting Final
Job Title: 
Supervisor: 
Reason for Leaving: 
Employer:  Dates Employed Work Performed
From To
Address: 
Telephone Number:  Hourly Rate/Salary
Starting Final
Job Title: 
Supervisor: 
Reason for Leaving: 
Employer:  Dates Employed Work Performed
From To
Address: 
Telephone Number:  Hourly Rate/Salary
Starting Final
Job Title: 
Supervisor: 
Reason for Leaving: 
Employer:  Dates Employed Work Performed
From To
Address: 
Telephone Number:  Hourly Rate/Salary
Starting Final
Job Title: 
Supervisor: 
Reason for Leaving: 

State any additional information you feel may be helpful to us in considering your application.
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is attached.  Yes    No

REFERENCES:  Please list three non-relatives.
Name Occupation City Phone Years Acquainted
1. 
2. 
3. 

APPLICANT'S STATEMENT

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the President of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.