Name *
Name
Address
Address
Phone
Phone
Are you eligible to work in the U.S.? *
Are you 18 years of age or older? *
During the last seven years have you ever been convicted of a crime other than a minor traffic offense? *
A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered.
Have you ever been terminated from employment or asked to resign by an employer? *
What shift are you available?
Can you read and write in English? *
Can you work overtime, including weekends?
Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation? *
Date you can start
Date you can start
Are you currently employed? *
If so, may we inquire of your present employer?
How did you hear about us?
Have you ever worked for this company before?
Education
Employment History
Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backward in time. Incomplete information could disqualify you from further consideration.
Date employment started
Date employment started
Date employment ended (if still employed use today's date)
Date employment ended (if still employed use today's date)
Address
Address
Phone Number
Phone Number
Date employment started
Date employment started
Date employment ended
Date employment ended
Address
Address
Phone Number
Phone Number
Date employment started
Date employment started
Date employment ended
Date employment ended
Address
Address
Phone
Phone
Date employment started
Date employment started
Date employment ended
Date employment ended
Address
Address
Phone
Phone
If there is not enough room on this form, please give a brief description of additional employment including dates, job titles, and employers.
References
Give the names of three persons not related to you, whom you have know at least three (3) years
Name 1
Name 1
Address
Address
Phone
Phone
Name 2
Name 2
Address
Address
Phone
Phone
Name 3
Name 3
Address
Address
Phone
Phone
Please read carefully before submitting
SMI Molding Inc is an equal opportunity employer. SMI Molding Inc does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service (For any applicable states, or based upon sexual orientation, gender identity and or gender expression). I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for SMI Molding Inc to hire me. If I am hired, I understand that either SMI Molding Inc or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of SMI Molding Inc has the authority to make any assurance to the contrary. I attest by submitting this form that I have given to SMI Molding Inc true and complete information on this application. No requested information has been concealed. I authorize SMI Molding Inc to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.