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Position: Front Desk Receptionist
Location: Corporate
Job Code: 11

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Personal Data

ADP TotalSource and its Clients fully subscribe to the principles of Equal Employment Opportunity. It is our policy to provide employment, compensation, and other benefits related to employment based on qualifications, without regard to race, color, religion, national origin, age, sex, veteran status, disability, or any other basis prohibited by federal, state or local law. In accordance with requirements of the Americans With Disabilities Act, it is our policy to provide reasonable accommodation upon request during the application process to eligible applicants in order that they may be given a full and fair opportunity to be considered for employment. As Equal Opportunity Employers, we intend to comply fully with applicable federal and State employment laws and the information requested on this application will only be used for purposes consistent with those laws. Applications are only accepted for positions currently available and will only be considered for thirty (30) days from today’s date or until the position applied for is filled, whichever first occurs.

If you are under 18 years of age, please specify your age. This information will be used only for child labor law purposes.

Are there any days, shifts or hours you will not work?

If yes, please explain:

Are you available for out of town work?

Will you work overtime, if required?

When will you be able to start work?

Have you taken any illegal drugs in the last 30 days?

Have you ever been a defendant in a civil action for an intentional tort (intentional commission of a wrongful act)?

Note: Answering “yes” does not automatically exclude you from further consideration for the position.

If yes, include nature of the intentional tort and the disposition of the action:

How did you learn of our company?

If referral, who were you referred by?

Have you ever applied or worked here before?

If yes, provide dates:

Have you ever applied or worked at ADP TotalSource before?

If yes, provide dates:

Are you legally authorized to work in the United States?

Will you now or in the future require sponsorship for employment visa status (e.g.,H-1B visa status)?

Note: The Federal Immigration and Reform and Control Act of 1986 requires that a DHS Employment Eligibility Verification “Form I-9” be completed for every new hire and that within 3 business days of beginning work every new hire must present to the employer documentation establishing his/her identity and authorization to work. This federal requirement must be satisfied as a condition of employment.


Resume Attachment

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Cover Letter
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Driving Record

Answer only if driving is a requirement of the job for which you are applying.

Do you have a valid drivers license?

Have you had any tickets?

If yes, please explain:

Has your license ever been suspended or revoked?

If yes, please explain:

Note for Massachusetts applicants ONLY: In the following question, the reference to DUI/DWI includes OUI. You are only required to list convictions within the past 5 years.

Do you have any DUI or DWI convictions?

If yes, please state when you were convicted and explain:


Residence History for the Past 7 Years:


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Education:

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Employment History

Please complete for all full-time or part-time employment beginning with most recent employer. You may include as part of your employment history any verified work performed on a volunteer basis.

Special Notice for Applicants for Commercial Motor Vehicle Driver Positions
All applicants seeking to drive a commercial motor vehicle as defined by 49 C.F.R. 383.5 should start with their most recent job, include active military assignments and voluntary employment and provide ten (10) years of history. (A separate sheet may be attached.) You must explain any gaps in your employment history.

49 C.F.R. 383.5 defines commercial motor vehicle as a motor vehicle or combination of motor vehicles used in commerce to transport passengers or property if the motor vehicle –

  1. Has a gross combination weight rating of 11,794 kilograms or more (26,001 pounds or more) inclusive of a towed unit(s) with a gross vehicle weight rating of more than 4,536 kilograms (10,000 pounds); or
  2. Has a gross vehicle weight rating of 11,794 kilograms or more (26,001 pounds or more); or
  3. Is designed to transport 16 or more passengers, including the driver; or
  4. Is of any size and is used in the transportation of hazardous materials as defined in this section.

All applicants seeking to drive a commercial motor vehicle as defined by 49 C.F.R. 390.5 should start with their most recent job, include active military assignments and voluntary employment and provide three (3) years of history. (A separate sheet may be attached.) You must explain any gaps in your employment history.

49 C.F.R. 390.5 defines commercial motor vehicle as any self-propelled or towed motor vehicle used on a highway in interstate commerce to transport passengers or property when the vehicle –

  1. Has a gross vehicle weight rating or gross vehicle weight or gross combination weight of 4,536 kilograms (10,000 pounds) or more, whichever is greater; or
  2. Is designed or used to transport more than 8 passengers (including the driver) for compensation; or
  3. Is designed or used to transport more than 15 passengers, including the driver, and is not used to transport passengers for compensation; or
  4. Is used in transporting material found by the Secretary of Transportation to be hazardous under 49 U.S.C. 5103 and transported in a quantity requiring placarding under regulations prescribed by the Secretary under 49 CFR, subtitle B, chapter I, subchapter C.

Please explain any gaps in your employment history.

Have you ever been discharged or forced to resign?

If yes, please explain:

Did you receive any discipline in the last 12 months of active employment?

If yes, please explain:

Were you given a performance evaluation within the last 12 months of active employment?

If yes, what was the range of scores used and what was your score?

Have you signed any non-compete or non-solicit agreement with any other employer that might restrict you from working for this company?

If yes, please explain:

(You may be required to furnish a copy of the agreement.)


Employment History:

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References (Not Related to You):






Military Service

(Complete only if you served in the military.)

 

Describe any military skills, training or experience you believe are relevant to the job applied for:


Criminal Record Information

All Applicants: You must answer all four questions below. When answering the following questions, you may exclude any records expunged, annulled, sealed, discharged, dismissed, erased under first-offender law or otherwise eradicated by statute or court order. You may also exclude a first conviction for any of the following misdemeanors; drunkenness, simple assault, speeding, minor traffic violations, affray or disturbance of the peace.

A criminal conviction will not necessarily be a bar to employment but will be considered in relation to specific job requirements.

  1. Have you been convicted of a felony within the last seven years?
 
  1. Have you been convicted within the last seven years of misappropriation of funds, embezzlement, or similar for other dishonest conduct; or an offense involving the use of a weapon; for burglary, robbery, breaking and entering or theft; or physical assault or other violent crime?
  1. Have you been convicted of or completed a period of incarceration within the past five years for any misdemeanor?

If the answer to the above question is "yes", please state whether you were convicted more than five years ago for any offense?

  1. A criminal conviction will not necessarily be a bar to employment. To help us evaluate your application, please describe your criminal conviction(s) including penalty (ies) imposed, listing the nature of your offense(s), and your rehabilitation since the conviction(s).

Questions


Applicants for Commercial Motor Vehicle Driver Positions

Note to Driver Applicants: (Part 391.21 (d)) The information provided in this section may be used, and prior employers may be contacted, for the purpose of investigating the applicant’s background as required by FMCSR Part 391.23. In compliance with FMCSA Regulations Section 40.25 (j), all driver applicants are required to answer the following two questions:

  1. Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?
  1. If you answered YES, have you successfully completed the DOT return-to-duty requirements?

    Note: You must provide documents supporting your successful completion of these requirements.

In order to drive a commercial motor vehicle, you must have a Commercial Driver’s License (CDL). Do you currently have a valid Commercial Driver’s License?

Please provide the following information for each unexpired motor vehicle license or permit which has been issued to you (include both CDL and non CDL) (Part 391.21(b)(5)):

Indicate all CDL Endorsements and Restrictions you currently hold:

Have you completed any special courses or training you believe will help you as a driver?

Have you received any safe driving award(s)?

If yes, please indicate when and from whom:

Vehicle Accident Record: Have you been involved in any accidents (preventable and non-preventable) as a driver during the previous three (3) years from the date of this application?

If Yes, please provide the date, location, nature of the accident (e.g., head-on, rear-end, over-turn, etc.), number of fatalities, number of injuries, and whether hazardous materials were spilled for each accident, starting with the most recent accident:

Violations: Please list all violations of motor vehicle laws or ordinances (excluding parking) for which you have been convicted, or have forfeited a bond or collateral during the three (3) years preceding this application. (Part 391.21 (b)(8))


Violations:

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Driving Privileges:

Has a State ever denied you a driver’s license, permit or privilege to operate a motor vehicle?

Has a State ever suspended or revoked your driver’s license, permit or privilege to operate a motor vehicle?

If the answer to either of the above questions is “yes,” please give details.

Have you ever been disqualified from driving for any of the following:

  1. Driving a commercial motor vehicle with a blood alcohol concentration of 0.04 or more?
  1. Driving under the influence of alcohol, as defined by State law?
  1. Refusing to submit to an alcohol test at the direction of State, local or enforcement personnel?
  1. Driving a motor vehicle with a gross vehicle weight rating of 10,001 pounds or more while under the influence of an illegal drug (including the improper use of a prescription drug)?
  1. Transporting, possessing or using illegal drugs (including the improper use of a prescription drug) while on-duty?
  1. Leaving the scene of an accident while operating a commercial motor vehicle?
  1. Committing a felony involving the use of a motor vehicle with a gross vehicle weight rating of 10,001 pounds or more?

Applicant's Acknowlegment

I hereby certify that I have read and fully understand this application. Prior to signing below, I had the opportunity to ask the Company and ADP TotalSource about this application and to clarify any questions I might have had concerning this application form.

I hereby certify that the answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts or incomplete answers in any application document may disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts in any application document may be cause for my dismissal at any time without prior notice. I consent to and authorize Company or ADP TotalSource to contact my former employers, references, and any and all other persons and organizations for information bearing upon my qualifications for employment. I further authorize the listed employers, schools and personal references to give the Company or ADP TotalSource (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have and hereby waive any actions which I may have against either party(ies) for providing a good faith reference.

I understand that the Company and ADP TotalSource may require additional Information from me and others regarding a driving position with the Company and ADP TotalSource and I agree to provide that information.

I EXPRESSLY AGREE AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT IS NOT FOR A SPECIFIC TERM, IS BASED ON MUTUAL CONSENT AND MAY BE TERMINATED BY ME OR MY EMPLOYER(S) WITH OR WITHOUT NOTICE OR CAUSE AT ANY TIME. I FURTHER UNDERSTAND THAT NO ORAL PROMISE, EMPLOYER(S) POLICY, CUSTOM, BUSINESS PRACTICE OR OTHER PROCEDURE (INCLUDING THE BASIC EMPLOYMENT POLICIES, PERSONNEL HANDBOOK OR ANY PERSONNEL MANUALS) CONSTITUTE AN EMPLOYMENT CONTRACT OR MODIFICATION OF THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ME AND THE EMPLOYER(S). I ALSO UNDERSTAND THAT THIS ASPECT OF MY EMPLOYMENT MAY NOT CHANGE ABSENT AN INDIVIDUAL WRITTEN AGREEMENT SIGNED BY BOTH ME AND THE PRESIDENT OF THE COMPANY OR OF ADP TOTALSOURCE.

I understand that applicants for certain positions may be required to qualify for employment based on additional employment criteria. For example, I may be required to take job-related tests; take a driver’s examination; submit to a background investigation; take a pre-employment drug test. If I am offered employment or start work before any required test is completed, my employment is contingent on a satisfactory result on all required tests. I authorize ADP TotalSource and its clients to release the results of background checks (if any) and my pre-employment drug/alcohol test (if any), any information on this application and any relevant information about me to each other and to other ADP TotalSource clients for whom I have applied for employment, and release ADP TotalSource and its clients from any and all claims related to the lawful release of this information. I further authorize the release of any background check results of any drug/alcohol test to any state or federal authority requesting such information and in response to a valid subpoena or other legal document.

I acknowledge that this application will remain active for 30 days from this date. If I have not heard from the Company at the conclusion of this 30 day period, it is my responsibility to complete a new application if I still wish to be considered for employment.

CALIFORNIA APPLICANTS ONLY: I understand the Company or ADP TotalSource may obtain, without using the services of a third party investigative consumer reporting agency, public records pertaining to my character, general reputation, personal characteristics or mode of living during its evaluation of my application for employment and, if employed, during my employment. By checking the following box, I waive my right to receive copies of public records obtained by the Company or ADP TotalSource.


Notification of Rights for Applicants for a Commercial Motor Vehicle Driver Position

The Information you provide in accordance with FMCSA regulations may be used, and your previous employers may be contacted for the purpose of investigating your safety performance history information (as required by 49 C.F.R. 391.23). You have the following rights regarding the investigative information that will be provided to the Company. (1) The right to review information provided by previous employers; (2) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the Company; (3) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and you cannot agree on the accuracy of the information. If you wish to review previous employer-provided investigative information, you must submit a written request to the Company, no later than 30 days after being employed or being notified of denial of employment. The Company will provide the requested investigative information to you within five (5) business days of receiving this written request, or five (5) business days of receipt of the requested information from the previous employer, whichever is later.


Certification for All Applicants - Please Read Carefully

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. (Part 391.21(b) (12))

 

 
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