Employment Application

Name*

Phone*

Email*

Referred By

Date Available To Start*

Position Applying For*

Education*

Some High School
High School Graduate
Some College
College Certificate
Associates Degree
Bachelors Degree
Graduate Degree

Are you legally eligible for employment in this country?*

Yes
No

Availability (select all that apply)*

Days (1st Shift)
Evenings (2nd Shift)
Nights (3rd Shift)
Weekends
Split Shifts
Rotating Shifts
Overtime

Type of employment desired (select all that apply)*

Full Time
Part Time
Temporary
Seasonal
Intern

Are you able to meet the attendance requirements?*

Yes
No

Have you been convicted of a felony in the last 5 years?*

Yes
No

Do you have any of the following relevant experience? (select all that apply)*

Hi-Lo
Order Picking
Inspection
Assembly
CNC
Pour Off
Roto-Lift
Grinding
Shell Core

Other Skills (Separate skills by comma)

Please list your experience beginning with your most recent job held.

Name of Employer*

Start Date*

End Date*

Job Title*

Start Pay

End Pay

Reason For Leaving*

Name of Employer*

Start Date*

End Date*

Job Title*

Start Pay

End Pay

Reason For Leaving*

References

Name (First/Last)*

Phone*

Number of Years Known

Name (First/Last)*

Phone*

Number of Years Known

Name (First/Last)*

Phone*

Number of Years Known

Resume Upload*

Max. file size: 100 MB.

Cover Letter Upload

Max. file size: 100 MB.

Application Consent*

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any application from consideration for employment on a basis prohibited by applicable local, state or federal law. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president. I also understand that if l am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard.

Application Date*

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Employment Application

Please list your experience beginning with your most recent job held.

References

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