Qualified applicants
receive equal consideration. No question is asked for the purpose of
excluding any applicant due to race, creed, color, national origin,
religion, age, sex, handicap, veteran status, marital status, sexual
orientation, or any other characteristic protected by law. We are equal
opportunity employer.
Please list chronologically, beginning with most recent experience.
Employer:
Address/City:
From (MM/YYYY):
To (MM/YYYY):
Supervisor:
Phone:
Salary:
Type of Work:
Reason for Leaving:
Employer:
Address/City:
From (MM/YYYY):
To (MM/YYYY):
Supervisor:
Phone:
Salary:
Type of Work:
Reason for Leaving:
Employer:
Address/City:
From (MM/YYYY):
To (MM/YYYY):
Supervisor:
Phone:
Salary:
Type of Work:
Reason for Leaving:
Education
Name & Location of School
Select Last Year Completed
Major Course
Diploma/Degree
High School
College/University
College/University
Business or Trade School
Personal Information
Member of the Drug-Free Workplace Network. Pre-Employment Drug Testing
is a Requirement.
Are you legally authorized to work in
the U.S.?: (If hired, you will be required to provide proof
of work authorization.)
Yes
No
Are you at least 18 years of age?:
Yes
No
Briefly describe skills you may have that you acquired in other
employment or armed forces:
Have you ever been convicted of a crime
(felony)?:
Yes
No
If
yes, give details: (Convictions are not automatic bar to
employment)
If
you are experienced operator of any office machines or equipment, please
list:
Typing speed?:
wpm
Shorthand?:
wpm
If
you are experienced operator of any plant machines or equipment, please
list:
Do
you have any other skills you wish to mention?:
Are you presently employed?:
Yes
No
If so, may we contact your present
employer?:
Yes
No
If hired, when would you be available?:
Employment References
List individuals familiar with your job qualifications (No relatives or
personal friends).
1) Name of Reference:
2) Name of Reference:
Occupation:
Occupation:
Address:
Address:
City/State/Zip:
City/State/Zip:
Phone:
Phone:
Relationship:
Relationship:
How long known:
How long known:
Invitation to Identify for Affirmative Action
Purposes
we are committed to the
employment and advancement of minorities, females, and individuals with
disabilities and veterans. If you fall into one of these protected
classifications, we invite you to identify yourself and receive coverage
under our company's Affirmative Action Plan. You may
inform us of your desire to benefit under the program at this time
and/or any time in the future.
Gender:
Male
Female
Indicate The Appropriate Race/Ethnic Group:
How Were You Referred To This Job:
Please read carefully before
submitting your application
All information contained in
this application is true and correct to the best of my knowledge and
belief. I understand that misrepresentations or omissions of any kind
may result in denial of employment or be cause for subsequent dismissal
if I am hired. I authorize the company to investigate my responses on
this application and contact any or all of my former employers or any
individuals familiar with me or my employment background for the purpose
of verifying any information, I have provided and/or for the purpose of
obtaining any information, whether favorable or unfavorable, about me or
my employment. I voluntarily and knowingly fully release and hold
harmless any person or organization that provides information pertaining
to me or my employment. I understand that upon receiving a job offer, a
physical examination and drug screening may be required. (Note: If this
is a job requirement, you will be notified.)
Regardless of whether or not I become employed by the company, I
recognize that this application is not and should not be considered a
contract of employment. I understand that employment at the company is
on an at-will basis and that my employment may be terminated with or
without cause, and without notice, at any time, at my option or the
company's unless specifically provided otherwise in a written employment
contract. I further understand that no company employee or
representative has the authority to enter into a contract regarding
duration or terms and conditions of employment other that an officer or
official of the company, and then only by means of a signed written
document. We have a policy of no smoking on the premises.
Check this box to certify that you have
read and accept the above statement.