EMPLOYMENT APPLICATION

Transcription

1 Name: Last First MI Date: Position/Area: Shift Related Position, please check shift(s) you are available and interested in: Office Hours: Office hours 8 am - 5 pm Production Hours: 1 st Shift 7am-3pm 2 nd Shift 3pm-11pm 3 rd Shift 11pm-7am Weekend Shift 1339 Continental Drive Eau Claire, WI Please print, fill out, and fax this Application to For any employment related questions please call EMPLOYMENT APPLICATION Welcome to Five Star Plastics, Inc. We are glad that you are interested in becoming a member of our team. Please complete the following information as completely as possible.

2 Tell us about yourself: Name: First, Middle, Last Soc. Sec.#. : Street City State Code How long at this address? Previous address, if less than 5 years at current address: Street City State Code How long at this address? Phone #: Other Phone # (Area Code) Number (Cellular, Pager, Mom s House, etc.) If necessary, best time to reach you What position are you applying for? Type of employment desired: Full-time Part-time Temporary Shift(s) Desired for Shift Related Positions: 7 am 3 pm 3 pm 11 pm 11 pm 7 am Weekend Shift Are you willing to work overtime if it is required? Yes No Have you worked for Five Star Plastics, Inc. before? Yes No If yes, where and when? How did you find out about this company/position? Are you at least 18 years of age? Yes No Hiring is subject to verification of legal age and U.S. work permit requirements. Do you understand the duties and requirements of this position? Yes No Have you ever served in the U.S. Military? Yes No Date of Service: Branch of Service Special Training? In the last seven years have you been convicted of a crime? Yes No If yes, please explain: Conviction will not necessarily prevent employment, depending upon position applied for and circumstance. Five Star Plastics, Inc. is an equal opportunity employer. If you require assistance or accommodation to complete this form, or during the interview process, please let us know.

3 Education (list the last 3 schools attended, beginning with school you attended most recently): Years Degree/ G.P.A. or Year Major School & Phone Number Attended Diploma Class Rank Graduated Subject Employment History (information about your past positions, beginning with most recent):

4 Comments, include explanation of any gaps in employment: Special Skills (skills, training, certificates, licenses, etc., relevant to position applying for):

5 References (name and telephone number of 3 business references, not related to you): Name Business Additional Information List any other information, which you would like us to consider: I submit that all the information is true. Any misrepresentation or material omission will be cause for my application to be canceled or employment terminated when discovered. Five Star Plastics, Inc. may contact all references, former employers and educational institutions to verify that this information is accurate. If I am hired, I understand that I am free to resign at any time, and that Five Star Plastics, Inc. has the right to terminate my employment at any time, subject to the requirements of any applicable law. This application is not an employment agreement or contract. I understand that no representative of Five Star Plastics, Inc., other than an authorized officer, has the authority to enter in to any such agreement and that any such agreement would be in writing and signed by an authorized officer and approved by the Board of Directors. Five Star Plastics, Inc. is an equal opportunity employer and complies with all applicable laws and regulations. No question on this application will be used to exclude any applicant for consideration on a basis, which is prohibited by local, state or federal law. I have read and understand this information and application. I understand that incomplete applications may not be considered for that reason. Signature of Applicant Date of Application