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    BATES MOVING & STORAGE COMPANY, INC.

    P.O. Box 1594 ★ Salisbury, MD 21804 ★ 27120 Ocean Gateway ★ Hebron, MD 21830 ★ 410-749-7117






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    RECORD OF EMPLOYMENT FOR THE PAST TEN (10) YEARS






























    YOUR EDUCATION

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    DRIVERS: EXPERIENCE AND QUALIFICATIONS













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    DRIVING EXPERIENCE



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    ACCIDENT RECORD FOR THE PAST FIVE (5) YEARS


    The undersigned hereby agrees that the foregoing information was furnished for the purpose of securing employment. The furnishing of same shall not obligate the prospective employer. If employment is secured, the first thirty (30) days of such employment shall be on a temporary basis during which period the employer may terminate the undersigned without any recourse on the part of the undersigned. A criminal background check, including an investigative consumer report, may be made in conjunction with this application. The undersigned understands that any false statement made on this application and uncovered at later date is cause for dismissal.

    SIGNATURE OF APPLICANT