APPLICATION FOR EMPLOYMENT
Name *
Name
(First/Middle/Last)
Address
Address
Desired Employment
Position
Date you can start:
Date you can start:
Education
NAME & LOCATION OF SCHOOL: High School
NAME & LOCATION OF SCHOOL: College/Tech School
Please Include All Previous Educational Opportunities with Name & Location: / Number of Years Attended: / Year Graduated: / Subjects Studied:
General
US Military or Naval Service:
Employment Experience
1.
Most Recent First
From:
From:
To:
To:
Address 1
Address 1
Supervisor
Supervisor
$
2.
From:
From:
To:
To:
Address 2
Address 2
Supervisor
Supervisor
$
References (3 Total)
Name
Name
Address
Address
Phone
Phone
Name
Name
Address
Address
Phone
Phone
Name
Name
Address
Address
Phone
Phone
Physical Record
Do you have any physical limitations that preclude you from any work for which you are being considered?
In case of emergency, notify:
In case of emergency, notify:
Name
Address
Address
Phone 3
Phone 3
Are you a United States citizen or alien authorized to work in the United States?
Special Skills and Qualifications
List professional, trade, business, or civic activities and offices held, (Exclude those which indicate race, color, religion, sex, or national origin)
Summarize special skills and qualifications acquired from employment or other experience that might help you with this job.
Use Dropbox or Google Doc
http://
Authorization
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning by previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that result from furnishing same to you. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.
Checkbox 1
"I authorize my former employers listed on Loos Machine & Automation, Inc.'s job application to give Loos Machine & Automation, Inc. all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. "