First name *
Last name *
Street Address
City and State
Phone *
Email *
Position *
Shift Preferred *
1st
2nd
3rd
Are you over age 18? *
Yes
No
Can you stand for 8-10 hours per day; lift/carry up to 50 lbs.; be physically able to walk, squat, crawl, climb, bend at waist, and use arms, hands and fingers repetitively and have the ability to work in a dusty atmosphere in hot and cold conditions? *
Yes
No
Have you worked for our company before? *
Names of relatives or friends who work here?
Do you have daily transportation to work? *
Yes
No
What High School did you attend?
Did you graduate from High School? *
Yes
No
If you graduated, what year did you graduate?
Any other post High School education?
Any special skills/machines?
Why are you looking for a job right now? *
Why did you leave your last job? *
Do you have factory experience? *
From your previous employment, what was your favorite job?
How many days were you absent from your last job? *
Do you think that was excessive? *
Have you ever received any type of awards/recognition for good work performance or good attendance?
If so, what type?
Have you ever received any type of warning or been disciplined for your attendance or performance?
If so, what type?
Would you be able to work overtime? *
Weekdays?
Weekends?
On Short notice?
Would you be able to adjust your personal schedule to work overtime, if needed? *
Yes
No
Previous Employer #1: *
Previous Employer #2
Personal references
Signature
form to email