Steel Green Manufacturing Employment Application

General Information

Name(Required)

First Middle Last

Home Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Business Phone

Mobile Phone(Required)

Email Address

Other Names

For verifying your employment and educational history, please list any other names you have used while employed or attended school. Include the dates the names were used.

Ability to perform essential duties(Required)

Are you able to perform the essential duties of the position for which you are applying, either with or without reasonable accommodations?

Yes

No

Explanation of inability to perform duties(Required)

Please describe the essential duties you cannot perform and any accommodations you require.

Legally eligible for employment in the US(Required)

All offers of employment are conditioned upon your ability to provide evidence of your right to be legally employed. Steel Green Manufacturing does not discriminate based on citizenship or national origin. Are you legally eligible for employment in the United States?

Yes

No

Education

Education(Required)

Type of School

Diploma/Degree type received (GED, H.S., B.A., etc.)

School Name, City, State

Major Subject / Course

Special Skills

Highlight your computer skills & knowledge:

Please list skills other than clerical (including any professional license or certification earned and foreign language proficiency):

References

In addition to the supervisor listed in the employment history section, list three professional references who can comment on your work performance.

Education(Required)

Name & Relationship

Address

Occupation / Company / Job Title

Telephone #

Other Relevant Experience

Please provide any other information that you think would be helpful to us in considering you for employment, such as additional work experience (paid or unpaid), seminars, articles or books published, activities and accomplishments. (You may exclude all information indicative of age, sex, race, religion, color, national origin, disability or any other status protected by law.) If you need additional space, please use the back of the page.

Other Relevant Experience

How Were You Referred to Us

Employee

School / College

Employment Agency

State or Local Agency

Newspaper / Publication

Other

If Employee

Please provide the name of the Employee

If School / College

Please provide the name of the School / College

If Employment Agency

Please provide the name and contact phone number of the Employment Agency

If State or Local Agency

Please provide the name of the State or Local Agency

If Newspaper / Publication

Please provide the name of the Newspaper / Publication

If Other

Please specify

Employment History

Please provide a complete employment history of all positions held for the last 10 years, including military, part-time, summer & volunteer work.

Present Employer(Required)

Present Employer Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Employer Phone(Required)

Position(Required)

Supervisor's Name(Required)

Supervisor's Title(Required)

Employment began (month / year):(Required)

Employment ended (month / year):(Required)

Salary information

Starting base salary

Ending base salary

Bonus

Reason for leaving:(Required)

May we contact your present employer?(Required)

Yes

No

If no, please explain:

Add another Employment Entry?

Yes

No

Name of Previous Employer

Previous Employer Address

Street Address City State / Province / Region ZIP / Postal Code

Employer Phone

Position

Supervisor's Name

Supervisor's Title

Employment began (month / year):

Employment ended (month / year):

Salary information

Starting base salary

Ending base salary

Bonus

Reason for leaving:

May we contact your previous employer?

Yes

No

If no, please explain:

Please Read & Sign

I certify that the answers given to the questions and the statements made (including statements on the attached resume and inserted forms, if any) on this application and in the hiring process are true and correct to the best of my knowledge. I understand that a false statement, a false answer, an omission or a misleading statement may result in a decision not to hire me, the withdrawal of any offer of employment, or the termination of my employment with the Company regardless of when false, misleading or erroneous information is discovered. In connection with my application for employment, I authorize the Company and any agent acting on its behalf to investigate and report on references given by me including former employers, personal references and educational institutions. I authorize the Company and any agent acting on its behalf to obtain information on my driving record if the position sought requires regular driving. I release the Company and any agent acting on its behalf, and my former employers from all liability of any nature due to requesting such information from any person. Where applicable, I agree that as a condition of continued employment, I must maintain the legal right to drive and be insured. I will comply with all traffic regulations, laws and ordinances in the operation of a motor vehicle while engaged in Company business. I understand that, as a condition of employment, I am required by federal law to produce documentary evidence of my identity and legal right to be employed in the United States. I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at the option of the Company. I may terminate my employment with or without cause and with or without notice. I further agree that the Company reserves the right to make unilateral changes in the terms and conditions of my employment and that this application does not create a binding employment contract between the Company and me. I understand and agree that the at-will nature of my employment may only be changed in writing by an authorized officer of the Company.

I agree(Required)

By checking the box below, you agree to the terms and conditions above.

I agree

Phone

This field is for validation purposes and should be left unchanged.

Employment Application

General Information

Job Information

Education

Special Skills

References

Other Relevant Experience

How Were You Referred to Us

Employment History

Please Read & Sign