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Employment Application
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It will take approximately 15 minutes to complete this form. If you cannot finish the form in one sitting, click the "Save and Continue Later" link at the bottom of the page.
General Information
First Name
*
Middle Name
Last Name
*
Email
*
Day Phone
Evening Phone
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
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Aruba
Australia
Austria
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Bahrain
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Belize
Benin
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Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
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Burkina Faso
Burundi
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Cameroon
Canada
Cayman Islands
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Chad
Chile
China
Christmas Island
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Congo, Democratic Republic of the
Cook Islands
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Curaçao
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Dominican Republic
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El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
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Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
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Gabon
Gambia
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Germany
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Hungary
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India
Indonesia
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Ireland
Isle of Man
Israel
Italy
Jamaica
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Korea, Republic of
Kuwait
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Libya
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Macao
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Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
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Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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North Macedonia
Northern Mariana Islands
Norway
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Palestine, State of
Panama
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Poland
Portugal
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Virgin Islands, U.S.
Wallis and Futuna
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Zimbabwe
Åland Islands
Country
Notify me of future job openings
Date of Application
*
MM slash DD slash YYYY
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 old?
*
If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a valid work permit
Yes
No
Have you ever been convicted of a crime or pleaded no contest for an offense or violation other than minor traffic violations?
*
Yes
No
If yes, explain 1) Nature of Crime, 2) Date of Conviction, and 3) State in Which Convicted
*
Have you ever applied at this company before?
*
Yes
No
If yes, when?
*
How were you referred to us?
*
Facebook
Window Sticker
Sponsorship
Employee
Employment Agency
Government Agency
Newspaper
Recruiter
School / College
State Job Service
Temporary Agency
Walk-In
Other
Employee Name
Newspaper Name
Other Name
Position Applying For
Production
CNC Operator
CNC Set Up / Lead Person
CNC Plant Manager / QC Manager
Other
Preferred Pay Range
*
Pay Range Type
*
Hourly Rate
Yearly Salary
Availability
Time Commitment
*
Part Time
Full Time
Are you available to work overtime and weekends, when necessary?
*
Yes
No
When can you start?
*
MM slash DD slash YYYY
Special Skills
If relevant, please describe computer skills, software knowledge
If relevant, please describe experience using production machines and equipment
Education
Please fill out all applicable fields.
High School
Name and Location
Last year completed
9
10
11
12
Diploma/Degree and Course of Study
Graduation date, if applicable
MM slash DD slash YYYY
Undergraduate
Name and Location
Last year completed
1
2
3
4
Diploma/Degree and Course of Study
Graduation date, if applicable
MM slash DD slash YYYY
Graduate
Name and Location
Last year completed
1
2
3
4
Diploma/Degree and Course of Study
Graduation date, if applicable
MM slash DD slash YYYY
Other (specify)
Name and Location
Last year completed
1
2
3
4
Diploma/Degree and Course of Study
Graduation date, if applicable
MM slash DD slash YYYY
Resume (Optional)
Resume
If you upload a resume, you do not have to complete the Employment History section below.
Max. file size: 10 MB.
Employment History
Please supply at least ten years of employment, or all of previous employment, starting with the most recent.
Employer 1
Name of Employer
Phone
Address
Street Address
City
ZIP / Postal Code
Job Title
Name of Supervisor
Reason for Leaving
Hourly Rate / Salary (Start)
Hourly Rate / Salary (End)
If currently employed, may we contact as a reference?
Yes
No
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer 2
Name of Employer
Phone
Address
Street Address
City
ZIP / Postal Code
Job Title
Name of Supervisor
Reason for Leaving
Hourly Rate / Salary (Start)
Hourly Rate / Salary (End)
If currently employed, may we contact as a reference?
Yes
No
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer 3
Name of Employer
Phone
Address
Street Address
City
ZIP / Postal Code
Job Title
Name of Supervisor
Reason for Leaving
Hourly Rate / Salary (Start)
Hourly Rate / Salary (End)
If currently employed, may we contact as a reference?
Yes
No
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer 4
Name of Employer
Phone
Address
Street Address
City
ZIP / Postal Code
Job Title
Name of Supervisor
Reason for Leaving
Hourly Rate / Salary (Start)
Hourly Rate / Salary (End)
If currently employed, may we contact as a reference?
Yes
No
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer 5
Name of Employer
Phone
Address
Street Address
City
ZIP / Postal Code
Job Title
Name of Supervisor
Reason for Leaving
Hourly Rate / Salary (Start)
Hourly Rate / Salary (End)
If currently employed, may we contact as a reference?
Yes
No
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer 6
Name of Employer
Phone
Address
Street Address
City
ZIP / Postal Code
Job Title
Name of Supervisor
Reason for Leaving
Hourly Rate / Salary (Start)
Hourly Rate / Salary (End)
If currently employed, may we contact as a reference?
Yes
No
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
References
Please list four references, who are not related to you, who can provide us with information about your qualifications to perform the job for which you are applying.
Reference 1
Name
Occupation
Phone
Address
Street Address
City
ZIP / Postal Code
Relationship
How long have you know this individual?
Reference 2
Name
Occupation
Phone
Address
Street Address
City
ZIP / Postal Code
Relationship
How long have you know this individual?
Reference 3
Name
Occupation
Phone
Address
Street Address
City
ZIP / Postal Code
Relationship
How long have you know this individual?
Reference 4
Name
Occupation
Phone
Address
Street Address
City
ZIP / Postal Code
Relationship
How long have you know this individual?
Performance Ability
Please review the job description and physical demands of the job applying for.
With respect to this particular job, are you able to perform the tasks outlined in these materials with or without accomodations?
*
Yes
No
Are you currently on layoff with another company?
*
Yes
No
Signature
*
Entering your name in this field denotes a signature and certifies that your answers are true and complete to the best of your knowledge.
Invitation to Indentify for Affirmative Action Purposes
Our company is commited to the employment and advancement of minorities, females, 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.
Completion of this form is voluntary and in no way affects the decision regarding your employment opportunity. The information provided will be held in strictest confidence, will be maintained in a separtae file, and will not be used in a manner inconsistent with the Acts.
Applicant Name
Date
MM slash DD slash YYYY
Position Applied For
Gender
Male
Female
Indicated Appropriate Race/Ethnic Group
White
Asian
Black / African American
Native American or other Pacific Islander
American Indian or Alaskan Native
Hispanic or Latino (White Race Only)
Hispanic or Latino (All Races)
Hispanic or Latino (All Other Races)
How were you referred to us?
Facebook
Window Sticker
Sponsorship
Employee
Employment Agency
Government Agency
Newspaper
Recruiter
School / College
State Job Service
Temporary Agency
Walk-In
Other
Other
Phone
This field is for validation purposes and should be left unchanged.
