Southtowne Machining, Inc.
Application For Employment
AN EQUAL OPPORTUNITY EMPLOYER
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age or disability.
Date of Application ______________________________
Applicant Data
Name_________________________________________________ -------------___---_____ ______________________________
Last First Middle Social Security Number
Current Address-----------------_______________________________________________________________________________________________
Number Street Apt
________________________________________________________________________________________________
City State Zip Code
Home Phone (_______)__________----______________ Work Phone (_______)________---___________________
What is the best time to call you at home? ______________ _
Are You under 18 years of age? ______Yes ________No If yes, you will be requested to submit state required work/age certificate.
Position Desired
For which position are you applying?_____________________________________________________________________
What are your compensation expectations? --------------______________ $ per hour
Work Schedule
What type of employment are you seeking? ______ Full Time ______ Part Time ______ Temporary
When could you start employment? ______________________________________________________________________
If part time, please indicate below the schedule you would be able to work:
Monday Tuesday Wednesday Thursday Friday
____to____ ____to____ ____to____ ____to____ ____to____
Employment History
How many different employers have you worked for in the past 5 years? _______________________________________
Have you been involuntarily terminated from an employer? ______Yes ______No
If yes, please explain all occurences_______________________________________________________________________
_____________________________________________________________________________________________________
May we contact your current employer? _____Yes_____No May we contact your former employer? _____Yes _____No
Personal and Professional References
Name____________________________________________________Phone______________________________________
Address_____________________________________________________________________________________________
Education
EDUCATION NAME/LOCATION DID YOU GRADUATE SUBJECT STUDIED/MACHINES USED
High School__ ______________________________________________________________________________________________
College____________________________________________________________________________________________________
Trade School_______________________________________________________________________________________________
FOR HUMAN RESOURCE USE ONLY
___________________________ ____________ ____________________ _____________________
Position Applied For Date Interviewer Action Taken
Starting Date ______________ Emp. Classification (PT, FT, Temp)_____________ Starting Wage _________________
Employment Record
List your current or most recent employer first. Include military service and/or any periods of self employment. You
must account for your three (3) most recent employers or a maximum of five (5) years of your most recent employment history.
Present or Last Employer
Company ____________________________________________________________________________________________
Address _____________________________________________________________________________________________
Telephone Number __________________________ Dates Employed: From ______________ To __________________
Last Position Held ___________________________________ Last Salary ______________________________________
Last Supervisor’s Name ________________________________________________________________________________
Reason For Leaving (be specific as possible)________________________________________________________________
What did you like best about job?_________________________________________________________________________
What did you like least about job?_________________________________________________________________________
Employer
Company ____________________________________________________________________________________________
Address _____________________________________________________________________________________________
Telephone Number __________________________ Dates Employed: From ______________ To __________________
Last Position Held ___________________________________ Last Salary ______________________________________
Last Supervisor’s Name ________________________________________________________________________________
Reason For Leaving (be specific as possible)________________________________________________________________
What did you like best about job?_________________________________________________________________________
What did you like least about job?_________________________________________________________________________
Employer
Company ____________________________________________________________________________________________
Address _____________________________________________________________________________________________
Telephone Number __________________________ Dates Employed: From ______________ To __________________
Last Position Held ___________________________________ Last Salary ______________________________________
Last Supervisor’s Name ________________________________________________________________________________
Reason For Leaving (be specific as possible)________________________________________________________________
What did you like best about job?_________________________________________________________________________
What did you like least about job?_________________________________________________________________________
PLEASE READ and SIGN
By my signature below, I promise that the information provided in this employment application (and accompanying resume or documentation, if any) is true and complete, and I understand that any false or misleading information or omissions may disqualify me from further consideration for employment and may lead to my immediate discharge from employment if discovered at a later date. I agree to immediately notify Southtowne Machining, Inc. if I should be convicted of a felony or any crime involving dishonesty, breach of trust, controlled substances, sexual misconduct, abuse or violence, while my application is pending or during my period of employment if hired.
I understand that the company may investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. In addition, I understand that the company reserves the right to conduct background investigations to determine my qualifications for employment. I authorize any person, school, current employer, past employer(s) and organizations named in this application (and accompanying resume, if any) to provide Southtowne Machining, Inc. with any information and opinion requested by Southtowne Machining, Inc. in connection with any application, and I release such parties from any liability in making such statements.
I understand that this application does not create a contract of employment. I understand that, if hired, I am obliged to comply with any and all current and subsequently adopted Southtowne Machining, Inc. policies. I understand and agree that, if hired, my employment is for no definite period of time, and may, regardless of the date of payment of my wages or salary, be terminated at any time for any reason, with or without notice. I understand that no person other that the President of Southtowne Machining, Inc. is authorized to change any terms mentioned in this employment application.
Applicants Signature ____________________________________________________ Date ______________________________________
In case of an emergency, please notify: Name _______________________________ Phone__________________________
Will you abide by the safety rules of this company? ________YES ________ NO