Job Application to work at Maui Soda and Ice Works Ltd. Step 1 of 5 20% Position you are applying for*Applicant InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Primary Phone*Cell PhoneDo you have a valid driver's license?*yesnoDriver's license State and #*Have you ever applied to or worked for MSIW?*YesNoIf so, when?Do you have any friends or relatives working for MSIW?*YesNoIf so, state their name(s) and relationship.How did you hear about us/this opening?*State briefly why you would like to work for MSIW*General Information about Employment DesiredCurrent employment statusAre you available to work on weekends?*YesNoHours available to work:If part-time, hours per week desired:Are you available to work on-call?*YesNoAre you available to work nights?*YesNoAre you available to work overtime?*YesNoIf hired, what date could you start work?Education and training(including on-the-job training)Did you graduate from High School*YesNoSchool/Location/SponsorCourse of StudyYears attendedCommunity college*YesNoSchool/Location/SponsorCourse of Study# of Years AttendedTrade School*YesNoSchool/Location/SponsorCourse of study# of Years AttenededCollege/University*YesNoSchool/Location/SponsorCourse of Study# of Years AttendedSeminars/Other*YesNoSchool/Location/SponsorCourse of Study# of Years Attended Special SkillsDo you have any experience, training, qualifications or skills which you feel make you especially suited to work at Maui Soda & Ice Works, Ltd.? If so, explain in detail below. Please include average operational time spent in operation of a Commercial Vehicle (CDL).Please enter any experience/training/qualifications or skillsComputer SkillsDates UsedLevel of ProficiencyComputer Skills [if applicable]Dates Used [if applicable]Level of Proficiency [if applicable] Employment HistoryList all previous employers starting with your present or most recent position (last ten years is sufficient).Name of Company 1*Address Street Address Address Line 2 City State / Province / Region Name of Supervisor:Telephone #Start & End Dates*Position:Duties:Reason for Leaving*Name of Company 2Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Name of SupervisorTelephone #Start Date / End DatePositionDutiesReason for LeavingName of Company 3Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Name of SupervisorTelephone #Start Date / End DatePositionDutiesReason for LeavingName of Company 4Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Name of SupervisorTelephone #Start Date / End DatePositionDutiesReason for Leaving ReferencesGive the names of three persons not related to you, whom you have known at least three (3) years. Name of Person 1*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email Years Aquainted*Name of Person 2*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail Years Aquainted*Name of Person 3*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail Years Aquainted* Please read and initial each paragraph belowI hereby authorize Maui Soda & Ice Works, Ltd. to thoroughly investigate my references, work records, education, and other matters related to my suitability for employment and further authorize my current and former employers to disclose to the company any and all letters, reports, and other information pertaining to my employment with them without giving me prior notice of such disclosure. In addition, I hereby release Maui Soda & Ice Works, Ltd., my current and 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.*Please InitialI understand that if offered employment, the offer may be contingent on my passing a pre-employment alcohol and drug screen and a pre-employment physical. By signing this application, I voluntarily agree to submit to a pre-employment alcohol/drug screen and pre-employment physical upon request. I understand that failure to pass the alcohol/drug screen and/or physical will result in withdrawal of the employment offer.*Please InitialIf hired, I also agree to submit to alcohol or drug testing as a condition of employment. I agree that Maui Soda & Ice Works, Ltd. may conduct alcohol or drug screening at its sole discretion with or without notice. I also understand that refusal to submit to an alcohol/drug screen will be considered a voluntary resignation of employment.*Please InitialI understand that if offered employment, Maui Soda & Ice Works, Ltd. may inquire into and consider any criminal conviction record that I may have after it makes a conditional offer of employment to me. Maui Soda & Ice Works, Ltd. may withdraw a conditional employment offer if I have a criminal conviction record which bears a rational relationship to the duties and responsibilities of the position for which I am applying. Any criminal conviction record that is more than 10 years old or that involves certain Family Court matters will not be considered.*Please InitialI understand that nothing contained in the application or conveyed to me during any interview which may be granted is intended to create an employment contract, implied or explicit, between me and Maui Soda & Ice Works, Ltd.. In addition, I understand and agree that if I am employed, my employment relationship with Maui Soda & Ice Works, Ltd. is strictly voluntary and at our mutual will. I understand that if employed, my employment is for no definite period and may be terminated at any time, with or without prior notice, with or without cause or reason, at the option of either myself or Maui Soda & Ice Works, Ltd., and that no promises or representations contrary to the forgoing are binding on Maui Soda & Ice Works, Ltd. unless made in writing and signed jointly by the President/CEO and myself*Please InitialI understand and agree that any future changes in my title, duties, compensation, working conditions, and/or Maui Soda & Ice Works, Ltd. benefits, policies, and procedures will not alter our will and arbitration agreements.*Please InitialI understand that if offered employment, I will, as a condition of employment, be required to submit proof of my identity and legal right to work in the United States on my first day of employment.*Please InitialIf the position applied for requires driving in the course of work, I understand that I will be required to possess a current and valid Hawai`i driver’s license and understand that I will be required to provide a copy of my official driving record and proof of insurance. I also understand that any offer of employment is contingent on my ability to be covered by Maui Soda & Ice Works, Ltd. auto insurance, if required for my position.*Please InitialI hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement on this application or on any documents used to secure employment shall be grounds for rejection of this application or for immediate discharge is I am employed, regardless of the time elapsed before discovery.*Please InitialSignature*Using your mouse, touchpad, tablet or touchscreen and giving us your signature constitutes your affirmation that all of the information provided above is true and accurate.Date Date Format: MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged.