Job Application

Name*

First Last

Date*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How long at above address?*

Phone*

Email

Position applying for:*

Desired Salary (be specific):*

Days/Hours available for work:

How many hours can you work weekly?*

When are you available to begin employment?*

Education: Please provide name of school, type, location, number of years completed, and major or degree*

Do you have a driver's license?*

What is your means of transportation to work?*

List your driver's license #, state, and expiration date:

Have you had any accidents in the past 3 years?*

How many?*

Have you had any moving violations in the past 3 years?*

How many?*

Experience

Work Experience: List your work experience for the past five years, beginning with your most recent job held. Include the following information: Name of Employer, location, name of supervisor, employment dates, job title, wage/salary, duties performed and the reason for leaving.*

May we contact your present employer?

If yes, provide supervisor name and phone number:

Please list two references other than relatives (include name, position, company, address and telephone).*

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position in which you are applying.

Other skills:

Additional information

Military

Have you ever been in the armed forces?*

Are you a member of the national guard?*

Specialty:

Entry Date:

Discharge Date:

Did you complete this application yourself?*

Name of document preparer:*

Voluntary Affirmative Action Information
Completion of information below is voluntary. We consider applicants for all positions without regard to race, color, religion, national origin, age, marital or veteran status, the presence of non-job related medication condition or handicap, or any other legally protected status.

Name

First Last

Position Applied For:

Date

Referral Source:

As required, we comply with government regulations; including Affirmative Action Obligations, where they apply. In an effort to comply with requirements regarding government record keeping, reporting, and other legal obligations, we ask that you complete this applicant data survey. Your cooperation is appreciated. Please be advised that your survey is not a part of your official application and will not be used in any hiring decisions.

Check One

Check if applicable

Vietnam Era Veteran
Disabled Veteran
Handicapped Individual
Veteran Other
Campaign

Waiver Form
Please read carefully

In exchange for the consideration of my job application by Industrial Steel, (hereinafter ,called "the Company"), I agree that: Neither the acceptance of this application, nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like, as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Industrial Steel, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President / Plant Manager of the Company. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers, (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contact. I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing during employment; (2) consent to and compliance with such policy is a condition of my employment; (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations. I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act. I further understand that my employment with the Company shall be probationary for a period of ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

Electronic Signature

First Last

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications. Thank you for completing this application form and for your interest in our Company.

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