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Thank you for your interest in CAT Scale Company. CAT Scale is the world leader in public weigh scales. We have been serving professional drivers since 1977 and are always looking for
motivated professionals to join our team. This form may be used for all positions at CAT Scale Company and any of our Iowa 80 Group locations. Please complete the form in its entirety. You will be notified if there is an appropriate opportunity. Thank you for your interest in Iowa
80 Group and CAT Scale Company.

Personal Information

Full Name (first name, middle initial, last name):
Address:	City:
State:	Postal Code:
Home Phone Number:	E-mail Address:
In case of emergency, call: Contact Email Address	Are you 18 or older? Yes No

Work Availability

Total hours available per week:

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
From:
To:

Are you legally able to be employed in the U.S.?
Yes No

Do you have transportation to work?
Yes No

How did you hear of the job?

School Most Recently Attended

Name:

Have you graduated?
Yes No

Last grade completed:

Location:

Are you currently enrolled?
Yes No

Favorite Subject:

Work History

(list most recent jobs first; if not applicable, list U.S. Military, volunteer work, or personal references)

Company [1]:

City:

Postal Code:

Phone:

Job Title:

Dates Worked:
From:
To:

Address:

State:

Supervisor:

Salary:
per

Reason for Leaving:

Company [2]:

City:

Postal Code:

Phone:

Job Title:

Dates Worked:
From:
To:

Address:

State:

Supervisor:

Salary:
per

Reason for Leaving:

Company [3]:

City:

Postal Code:

Phone:

Job Title:

Dates Worked:
From:
To:

Address:

State:

Supervisor:

Salary:
per

Reason for Leaving:

During the past seven years, have you ever been convicted of a crime?
(other than a misdemeanor)
Yes No

Please read carefully...

I certify that the information contained on this application is correct to the best of my knowledge, and understand that any omission or erroneous information is grounds for dismissal in accordance with the policy of Iowa 80 Group.
I authorize the references listed above to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
I acknowledge that Iowa 80 Group reserves the right to amend or modify policies at any time, without prior notice. My application for employment is made with the understanding that nothing contained in this application or in the granting of an interview is intended to create a contract between Iowa 80 Group and myself for either employment or for providing of any benefit. My employment at Iowa 80 Group is at will. This means I am free to terminate my employment at any time, for any reason, with or without cause, and Iowa 80 Group retains the same rights.
Iowa 80 Group takes pride in being an Affirmative Action and Equal Opportunity Employer. Various federal, state and local laws prohibit discrimination on account of race, color, religion, sex, age, national origin, disability or veteran's status. It is Iowa 80 Group's policy to comply with these laws, as applicable, and information requested on this application will not be used for any purpose prohibited by law.
Iowa 80 Group regards drug abuse as a serious problem and maintains a drug-free environment. If I accept a job offer, a drug test, confirmed negative, will be required before the first day on the job. In addition, as a safeguard to my health and the health of my fellow employees, I will submit to such physical examinations, medical surveillance programs and tests for substance abuse during the course of employment as the Company may deem reasonable and necessary. Refusal or failure to take a test: immediate termination.
It is also my understanding, that if my employment with Iowa 80 Group lasts less than six weeks from my date of hire, I will reimburse Iowa 80 Group the entire amount of the cost of the drug screen.

Can you perform all job duties?
Yes No

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