Please Read Carefully and Complete by Printing in Ink or Typing. An Equal Opportunity Employer
Please Read Carefully and Complete by Printing in Ink or Typing. An Equal Opportunity Employer
First
MI
For Personnel use only Type(s) of work desired State ZIP Home telephone
A By your college
E Open house
F Walk-in
G Other
Please read carefully and complete by printing in ink or typing. An Equal Opportunity Employer
We are an equal opportunity employer, and we do not and will not discriminate on the basis of race, religion, national origin, sex, age, handicap, marital status, or status as a disabled veteran. Information provided on this application will not be used for any discriminatory purpose.
Employment Record Starting with present or most recent, list all previous employers. Include self-employment and summer and part-time jobs. If more space is required, please continue on a separate sheet. You may attach a resume, but complete this application as well. Last or present company Street address City Supervisors name Base salary Reason for leaving Last or present company Street address City Supervisors name Base salary Reason for leaving Dates worked From State Type of business Phone number ZIP code Phone number To Type or classification of job Brief description of job duties Dates worked From State Type of business Phone number ZIP code Phone number To Type or classification of job Brief description of job duties
Educational History School name High school Technical/trade (after high school)
Graduated Yes No
Degree
Other education/training
Outside Activities (Exclude those indicating race, color, religion, sex, national origin, age, or handicap.) Professional memberships, certificates, or licenses held
Principal hobbies
To be completed by applicant for shop/plant work Type of machines operated Years experience
Please list other skills and/or equipment/language experience you have acquired
Served apprenticeship
Yes No
Type:
From
To
Professional/Work References List two past supervisors and one person who is not related to you who have knowledge of your qualifications for the position for which you are applying. Name Title/relationship Address Phone no. Occupation (street, city, state, ZIP code) (include area code)
May we contact your present employer? Wage or salary required Date available
Yes No
I hereby certify that the answers and other information on this application are true and correct and that I understand any misrepresentation or omission of facts on my part will be justification for separation from the companys service, if employed. I understand that my employment may be contingent upon receipt of an alien registration number, verification of birth, and any other pertinent information bearing upon my employment, and that my continued employment depends upon the will of the company or myself.
_____________________________________________ Date
______________________________________________________ Signature
If any of your educational or employment records are under other than the above name, please provide other names.
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