Applicant Information First Name:
Home Phone:
Email Address:
Current Address:
City:
State:
Employment Positions
Position applying for:Foreman Machnist Operator Helper
Are you applying for:
What days are you
available for
work?
If applying for temporary
work, when will you be
available?
If hired, on what date can
you start working?
1
2
3
4
5
6
7
8
9
10
11
12
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
2007
2008
Can you work on the weekends?
Can you work evenings?
Are you available to work
overtime?
Salary desired:
$
Personal Information: Have you ever applied to /
worked for Company before?
If yes, please explain (include
date):
Do you have any friends,
relatives, or acquaintances
working for Company?
If yes, state name &
relationship:
If hired, would you have
transportation to/from work?
Are you over the age of 18?
(If under 18, hire is subject to
verification of minimum legal
age.)
If hired, would you be able
to present evidence of your U.S.
citizenship or proof of your
legal right to work in the
United States?
If hired, are
you willing to
submit to and
pass a
controlled
substance test?
Are you able
to perform the
essential
functions of the
job for which
you are
applying, either
with / without
reasonable
accommodation?
If no,
describe the
functions that
cannot be
performed
(Note:
Company complies
with the ADA and
consider
reasonable
accommodation
measures that
may be necessary
for eligible
applicants/employees
to perform
essential
functions. It is
possible that a
hire may be
tested on
skill/agility
and may be
subject to a
medical
examination
conducted by a
medical
professional.)
Have you
ever been
convicted of a
criminal offense
(felony or
misdemeanor)?
If yes,
please describe
the crime -
state nature of
the crime(s),
when and where
convicted and
disposition of
the
case.:
(Note: No
applicant will
be denied
employment
solely on the
grounds of
conviction of a
criminal
offense. The
date of the
offense, the
nature of the
offense,
including any
significant
details that
affect the
description of
the event, and
the surrounding
circumstances
and the
relevance of the
offense to the
position(s)
applied for may,
however, be
considered.)
Education,
Training and
Experience
High School:
School
address:
School city,
state,
zip:
Number of
years completed:
Did you
graduate?
Degree / diploma
earned:
College / University
School name:
School
address:
School city,
state,
zip:
Number of
years completed:
Did you
graduate?
Degree / diploma
earned:
Vocational
School Name:
Address:
City, state,
zip:
Number of
years completed:
Did you
graduate?
Degree /
diploma?:
Military::
Branch:
Rank in
Military:
Total Years of
Service:
Skills/duties:
Related
details:
Do you speak, write or understand any foreign
languages?
If yes, describe which languages(s) and how
fluent of a speaker you consider yourself to be.
Do you have any other experience, training,
qualifications, or skills which you feel should be
brought to our attention, in the case that they make you
especially suited for working with us?
If yes, please explain
Employment History Are you currently employed?
If you are currently employed, may we contact
your current employer?
Below, please describe past and present
employment positions, dating back five years.
Please account for all periods of unemployment.
Even if you have attached a resume, this section
must be completed.
Name of
Employer:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references?
Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references?
References List below three persons who have knowledge of
your work performance within the last four
years. Please include professional
references only.
Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:
Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:
Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:
Please Read and Initial Each
Paragraph, then Sign Below I certify that I have not
purposely withheld any
information that might adversely
affect my chances for hiring. I
attest to the fact that the
answers given by me are true &
correct to the best of my
knowledge and ability. I
understand that any omission
(including any misstatement) of
material fact on this
application or on any document
used to secure can be grounds
for rejection of application or,
if I am employed by this
company, terms for my immediate
expulsion from the company.
I understand that if I am
employed, my employment is not
definite and can be terminated
at any time either with or
without prior notice, and by
either me or the company.
I permit the company to
examine my references, record of
employment, education record,
and any other information I have
provided. I authorize the
references I have listed to
disclose any information related
to my work record and my
professional experiences with
them, without giving me prior
notice of such disclosure. In
addition, I release the company,
my former employers & all other
persons, corporations,
partnerships & associations from
any & all claims, demands or
liabilities arising out of or in
any way related to such
examination or revelation.
Applicant's Signature:
Date:
Please attach Resume:
Raven
Machine Co.