APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT
Strobel Manufacturing, Inc. is an equal opportunity employer. We are dedicated to a policy of non discrimination in employment on any basis including race, color, ancestry, age, sex, sexual orientation, gender, gender identity or expression, religion, disability, medical condition, genetic information, national origin, military or veteran status, or marital status. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.
APPLICANT INFORMATION
First Name*
Middle
Last Name*
Address*

Address

Street Address Line 2

CityState

Zip
Email Address*
example@example.com
Telephone*
EMPLOYMENT POSITIONS
Position(s) applied for*
Be specific or you can enter ANY
Are you available to work overtime?*

YesNo
Available Start Date

MonthDayYear
Date
Wage Desired*
PERSONAL INFORMATION
Have you ever applied to/worked for the company before?*

YesNo
If yes, when?*
If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?*

YesNo
Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age)*

YesNo
Have you ever been convicted of, pleaded guilty to, pleaded no contest or nolo contendere to, been paroled for, received probation or deferred judgment for, or received a suspended imposition/ execution of sentence or judgment for any felony or misdemeanor (other than a minor traffic violation) in any jurisdiction?*

YesNo
If yes, please describe the crime - state nature of the crime(s), location and dates, disposition of the case.
Note: No applicant will be denied employment solely on the grounds of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, the surrounding circumstances and the relevance of the offense to the position(s) applied for will all be considered.
EDUCATION, TRAINING, & EXPERIENCE
High School Name:
High School City, State, Zip
Number of years completed
Did you graduate High School?

YesNo
Degree/Diploma earned
College/University Name:
College/University City, State, Zip
Number of years completed:
Did you graduate College/University?

YesNo
Degree/Diploma earned
Vocational School Name:
Vocational School City, State, Zip
Number of years completed:
Did you graduate Vocational School?

YesNo
Degree/Diploma/Certification earned
Are there other experiences, skills or qualifications relating to the position for which you applied?
If applying for a welder position, are you certified?

YesNo
Where is your welding certificate from?
PREVIOUS EMPLOYMENT INFORMATION
Are you currently employed?*

YesNo
If you are currently employed, may we contact your current employer?*

YesNo
List most recent employer first, must include phone numbers.
1. Company Name
Phone
Company Address
Position
Employed From: Date to: Date
Reason for Leaving
Last Wage
2. Company Name
Phone
Company Address
Position
Employed From: Date to: Date
Reason for Leaving
Last Wage
3. Company Name
Phone
Company Address
Position
Employed From: Date to: Date
Reason for Leaving
Last Wage
PERSONAL REFERENCES

(Other than family members or previous employers)
1. Name*
Phone ( )*
2. Name*
Phone ( )*
3. Name*
Phone*
Please Read and Initial Each Paragraph, then Sign Below
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.*
Initials
I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation. *
Initials
I understand that the Company may require me to undergo a background check and/or pre-employment drug and alcohol testing after receiving a conditional offer of employment. Applicants will receive additional information about the foregoing and may be required to sign additional authorizations regarding the same. I understand and acknowledge that any offer of employment will be conditioned upon my successful completion of any background check or drug and/or alcohol test that is conducted.*
Initials
The facts set forth in this application for employment are true and complete. I further understand that this application is notintended to be a contract of employment, nor does this application obligate the company in any way if the company decides to employ me. I understand and agree that if I am employed; my employment is at will and can be terminated by either party with or without advance notice, at any time, for any reason or no reason unless otherwise stated in a written employment agreement signed by the Company President.
Applicant’s Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

APPLICATION FOR EMPLOYMENT

APPLICANT INFORMATION

EMPLOYMENT POSITIONS

PERSONAL INFORMATION

EDUCATION, TRAINING, & EXPERIENCE

PREVIOUS EMPLOYMENT INFORMATION

List most recent employer first, must include phone numbers.

PERSONAL REFERENCES

Please Read and Initial Each Paragraph, then Sign Below