Please include a copy of your

							Please include a copy of your                                                                                  location accepted by
driver’s license and social
security card. Thank you!!!

   DRIVER’S APPLICATION FOR EMPLOYMENT
                                               W. C. McQuaide, Inc.
                                  153 Macridge Avenue Johnstown PA 15904-2995
                                                                 814-269-6000

                                                     (answer all questions-please print)

  Facility locations: Number in order of preference
  ___Homer City, PA ___Johnstown, PA ___Sidman, PA                                ___Cumberland, MD             ___Indiana, PA

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to
race, color, religion, sex, national origin, age, marital status, or non-job related disability.

Position(s) Applied for                                                                                                   Date

Would you be willing to relocate? ___yes ___no                                Social Security No.

Name
                      Last                                        First                                        Middle

Address
                      Street                                                             City

                                                                                         Phone
                      State                            Zip

ADDRESS                                                                                                           How long?
FOR PAST              Street                           City                   State & Zip
THREE                                                                                                              How long?
YEARS                 Street                           City                   State & Zip

Do you have the legal right to work in the United States?

Date of Birth                                                     If no can you provide proof of age?
 (Required for Truck Drivers)

Have you worked for this company before?                                      Where?

Date: From                         To                     Rate of pay                           Position

Reason for leaving

Are you now employed?                                  If not, how long since leaving last employment?

Who referred you?(be specific)                                                           Rate of pay expected

Is there any reason you might be unable to perform the functions of the job for which you have applied [as described
in the attached job description]?

If yes, explain if you wish
                                        MILITARY STATUS
HAVE YOU SERVED IN THE U.S. ARMED FORCES?      BRANCH


                                          EDUCATION
CIRCLE HIGHEST GRADE COMPLETED: 1 2 3 4 5 6 7 8 HIGH SCHOOL: 1 2 3 4 COLLEGE: 1 2 3 4
LAST SCHOOL ATTENDED
                                          (Name)                                                               (City)