| Job
Applied for
|
| Date
|
| Are
you seeking: Full-time
Part-time
Temporary
employment? |
| When
could you start work?
|
| |
| Last
Name
|
| First
Name
Middle Name
|
| Telephone
Number
|
| Present
Street Address
|
| City
State
Zip
|
| |
| Are
you 18 years of age or older? Yes
No
(If
you are hired, you may be required to submit proof of age.) |
| Social
Security Number
|
| If
hired, can you furnish proof you are eligible to work in the
U.S.? Yes
No
|
| |
| Have
you ever applied here before? Yes
No
If
yes, when?
|
| Were
you ever employed here? Yes
No
If
yes, when?
|
| |
| Have
you ever been convicted of any law violation? Include any plea
of "guilty" or "no contest." Exclude minor
traffic violations. Yes
No
|
If
yes, give details
(A conviction will not necessarily disqualify an applicant for
employment.) |
| If
employed, do you expect to be engaged in any additional business
or employment outside of your job? Yes
No
|
| If
yes, give details
|
| For
Driving Jobs ONLY: Do you have a valid driver's license? Yes
No
|
| Driver's
License Number
|
| Class
of License
State Licensed in
|
| Have
you had your license suspended or revoked in the last 3 years? Yes
No
|
| |
| List
professional, trade, business or civic activities and offices
held. (Exclude labor organizations and memberships which reveal
race, color, religion, national origin, sex, age, disability
or other protected status.) |
|
|
| |
| List
Name and Address of Schools |
| High
School or GED
|
| Number
of Years Completed
|
| Diploma/Degree/Certificate
|
| Subjects
Studied
|
| |
| College
or University
|
| Number
of Years Completed
|
| Diploma/Degree/Certificate
|
| Subjects
Studied
|
| |
| Vocational
or Technical
|
| Number
of Years Completed
|
| Diploma/Degree/Certificate
|
| Subjects
Studied
|
| |
| What
skills or additional training do you have that relate to the
job for which you are applying? |
|
|
| What
machines or equipment can you operate that relate to the job
for which you are applying? |
|
|
| |
| Employment
History |
| List
names of employers in consecutive order with present or last
employer listed first. Account for all periods of time including
military service and any periods of unemployment. if self-employed,
give firm name and supply business references. Note: A job offer
may be contingent upon acceptable references from current and
former employers. |
| |
| Name
of Employer
|
| Address
Telephone
|
| City
State
Zip Code
|
| Job Title and Duties
|
| Dates
of Employment (MO/YR) From
To
|
| Pay:
Start $
Final $
|
| Supervisor(s)
|
| Reason
for Leaving
|
| |
| Name
of Employer
|
| Address
Telephone
|
| City
State
Zip Code
|
| Job Title and Duties
|
| Dates
of Employment (MO/YR) From
To
|
| Pay:
Start $
Final $
|
| Supervisor(s)
|
| Reason
for Leaving
|
| |
| Name
of Employer
|
| Address
Telephone
|
| City
State
Zip Code
|
| Job Title and Duties
|
| Dates
of Employment (MO/YR) From
To
|
| Pay:
Start $
Final $
|
| Supervisor(s)
|
| Reason
for Leaving
|
| |
| Name
of Employer
|
| Address
Telephone
|
| City
State
Zip Code
|
| Job Title and Duties
|
| Dates
of Employment (MO/YR) From
To
|
| Pay:
Start $
Final $
|
| Supervisor(s)
|
| Reason
for Leaving
|
| |
| Have
you worked or attended school under any other names? Yes
No
|
| If
yes, give names
|
| |
| Are
you presently employed? Yes
No
|
| If
yes, whom do you suggest we contact?
|
| |
| Give
three references, not relatives or former employers. |
| Name
|
| Address
|
| Phone
|
| |
| Name
|
| Address
|
| Phone
|
| |
| Name
|
| Address
|
| Phone
|
| |
| PLEASE
READ EACH STATEMENT CAREFULLY BEFORE ACCEPTING |
| I
certify that all information provided in this employment application
is true and complete. I understand that any false information
or omission may disqualify me from further consideration for
employment and may result in my dismissal if discovered at a
later date.I authorize the investigation of any or all statements
contained in this application. I also authorize, whether listed
or not, any person, school, current employer, past employers
and organizations to provide relevant information and opinions
that may be useful in making a hiring decision. I release such
persons and organizations from any legal liability in making
such statements.I understand I may be required to successfully
pass a drug screening examination. I hereby consent to a pre-
and/or post-employment drug screen as a condition of employment,
if required.I understand that if I am extended an offer of employment
it may be conditioned upon my successfully passing a complete
pre-employment physical examination. I consent to the release
of any or all medical information as may be deemed necessary
to judge my capability to do the work for which I am applying.I
UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT,
OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED
CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE
PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE
AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED
PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE
PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I
HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT
MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH
OR WITHOUT NOTICE.I have read, understand, and by my signature
consent to these statements. |
| I
Accept
Name
Date
|
| Your
name and date serve as acceptance of the above statements. |
| |
| This
application for employment will remain active for a limited
time. Ask the organization's representative for details. |
| |
| Applicant
Questionnaire |
| 1.
What are your short-term and long term goals in life? |
|
|
| 2.
What do you consider an average work week? |
|
|
3.
a)
How do you feel about working 50 hours a week?
|
b) How do you feel about working a night shift, i.e. 2:15pm
– 10:45pm?
|
| 4.
Will long hours present a problem to your family? |
|
|
| 5.
Do you maintain your own vehicle? |
|
|
| 6.
What are you looking for in an employer? |
|
|
| 7.
If you were offered two jobs at the same pay and with the same
benefits, what else would you consider to determine for which
company to work? |
|
|
| 8.
Why do you want to work for Lewis Bolt & Nut Company? |
|
|
| 9.
What is the best thing and the worst thing you’ve ever
heard about Lewis Bolt & Nut Company? |
|
|
| 10.
What would be your reaction if hired by Lewis Bolt & Nut
Company, but not assigned to any work in your specialized field? |
|
|
| 11.
If you were working on an assembly line and couldn’t keep
up with it, what would you do? |
|
|
| 12.
If somebody who had worked on an assembly line for some time
kept passing you bad parts, what would you do? |
|
|
| 13.
Do you share your ideas with others? |
|
|
| 14.
What is your definition of teamwork? |
|
|
| 15.
What do you believe are some of the advantages and disadvantages
of teamwork in the workplace? |
|
|
| 16.
How do you define the word “integrity?” |
|
|
| |
|
|
