Full Name:
Last, First, Middle |
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| Current Address: |
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| City, State, Zip: |
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| Telephone: |
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| Do you have a legal right to be employed in the United States? |
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Yes No |
| Proof of citizenship or immigration status will be required upon employment.
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| Type of work applied for: |
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| Do you have machine shop experience? |
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Yes No |
| What date can you start work? |
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| Do you have restrictions on your availability to work certain hours of the day or days of the week? |
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Yes No |
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What specific job skills would you bring to this position?
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| Are you currently employed? |
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Yes No |
| If currently employed, may we contact your employer? |
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Yes No |
| Click the highest grade you have completed in school: |
High School
9
10
11
12
|
College
1
2
3
4
|
| Have you attended a Trade School or served an apprenticeship? |
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Yes No |
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If "Yes," please describe:
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| Have you served in the Armed Forces? |
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Yes No |
| Are you a Viet Nam Era Veteran? |
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Yes No |
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Please describe your job-related Armed Forces duties and/or training:
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EMPLOYMENT RECORD: (beginning with most recent employment) |
Employer 1
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| From: Date, Month, Year |
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| To: Date, Month, Year |
|
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Employer Name & Address:
|
| Salary: |
|
|
Reason for leaving:
|
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Job Title & Principle Duties:
|
| Name and Title of Supervisor: |
|
Employer 2
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| From: Date, Month, Year |
|
| To: Date, Month, Year |
|
|
Employer Name & Address:
|
| Salary: |
|
|
Reason for leaving:
|
|
Job Title & Principle Duties:
|
| Name and Title of Supervisor: |
|
Employer 3
|
| From: Date, Month, Year |
|
| To: Date, Month, Year |
|
|
Employer Name & Address:
|
| Salary: |
|
|
Reason for Leaving:
|
|
Job Title & Principle Duties:
|
| Name and Title of Supervisor: |
|
Employer 4
|
| From: Date, Month, Year |
|
| To: Date, Month, Year |
|
|
Employer Name & Address:
|
| Salary: |
|
|
Reason for Leaving:
|
|
Job Title & Principle Duties:
|
| Name and Title of Supervisor: |
|
REFERENCES: |
Reference 1
|
| Name: |
|
| Address: |
|
| Phone Number: |
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Reference 2
|
| Name: |
|
| Address: |
|
| Phone Number: |
|
Reference 3
|
| Name: |
|
| Address: |
|
| Phone Number: |
|
|
| Have you worked with us previously? |
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Yes No |
| From: |
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| To: |
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| Prior Position: |
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| Supervisor's Name: |
|
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Reason for Leaving:
|
|
