Submit Application Without CDL

Date of Application*

Referred By

Position(s) Applying for*

Is there any reason you might be unable to perform the functions of the job for which you are applying?*

Yes

No

Please Explain:*

Applicant Name*

First Middle Last

Social Security Number*

Phone*

Date of Birth*

Have you worked for Diamond before?*

Yes

No

Position Held*

Date of Hire*

Date of Termination*

Are you employed now?*

Yes

No

Date Available to Work*

Legal to work in the United States?*

Yes

No

Please Provide Your Residency for the Past Three (3) Years

Current Address*

Street Address Address Line 2 City State ZIP Code

How long have you been at this residence?*

Previous residence?

Add Another Residence

Previous Residence Address*

Street Address Address Line 2 City State ZIP Code

How long did you live at this residence?*

Previous residence?

Add Another Residence

Previous Residence Address*

Street Address Address Line 2 City State ZIP Code

How long did you live at this residence?*

Drivers License Type (Class)*

Drivers License Number*

State*

State

Expiration Date*

Has any license, permit or privilege ever been suspended or revoked?*

Yes

No

Please Explain Why:*

Additional License?

Add Another License

Drivers License Type (Class)*

Drivers License Number*

State*

State

Expiration Date*

Additional License?

Add Another License

Drivers License Type (Class)*

Drivers License Number*

State*

State

Expiration Date*

All Applicants must provide Complete Information for their three (3) most recent employers. Applications without complete employment history may not be considered.

Employer*

Employment Start Date*

Employment End Date*

Employer Address*

Street Address Address Line 2 City State ZIP Code

Contact Person*

First Last

Position Held*

Wages*

Reason for Leaving

Additional Employer?

Add Another Employer

Employer*

Employment Start Date*

Employment End Date*

Employer Address*

Street Address Address Line 2 City State ZIP Code

Contact Person*

First Last

Position Held*

Wages*

Reason for Leaving*

Additional Employer?

Add Another Employer

Employer*

Employment Start Date*

Employment End Date*

Employer Address*

Street Address Address Line 2 City State ZIP Code

Contact Person*

First Last

Position Held*

Wages*

Reason for Leaving*

Highest Education Completed*

Some Grade/High School

High School Graduate/GED

Some College

College Graduate

How many years did you attend grade school/high school?*

Last School Attended*

Grade/High School Location*

City State

How many years did you attend college?*

Last College Attended*

College Location*

City State

Highest or Most Relevant Degree Earned*

Approx. Graduation Date*

College Where You Received Your Degree*

Have you attended a trade school?*

Yes

No

Last Trade School Attended*

Trade School Location*

City State

List any courses, training, or experience that will help you at the position applying for:

Background Check

Disclosure and Authorization Regarding Background Investigation for Employment Purposes. Diamond Services Company (the “Company”) may request from a consumer reporting agency and for employment-related purposes, a “consumer report(s)” (commonly known as “background reports”) containing background information about you in connection with your employment, or application for employment, or engagement for services (including independent contractor or volunteer assignments, as applicable). HireRight, LLC (“HireRight”) will prepare or assemble the background reports for the Company. HireRight is located and can be contacted at 3349 Michelson Drive, Suite 150, Irvine, CA 92612, (800) 400-2761, www.hireright.com. The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information.

Signature*

By signing, I hereby authorize Company to obtain the consumer reports described above about me.

To Be Read by the Applicant

By submitting this form, I certify that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize you to make such investigations and inquire of my personal, employment, criminal history, medical history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers and other persons from all liability in responding to inquires and releasing information in connection to my application. 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 Diamond Service Company.