Application for Employment

*Position Applying for:

*Date

*First Name

0/20

Middle Initial

0/1

*Last Name

0/20

Email Address

Home Phone

Cell Phone

*Street Address

0/50

City

0/25

State

0/25

*Zip

Social Security Number

Are you over 18?

Yes     No    

Are you legally eligible for employment in the United States?

Yes     No    

*Have you previously applied for a position with Cast Nylons?

Yes     No    

If yes, when?

Have you ever been employed by Cast Nylons?

Yes     No    

If yes, when?

When will you be available to begin work?

Are you related to anyone currently working for Cast Nylons?

no     yes    

If Yes, please list the name and relationship

Are you able to perform all of the essential duties of the job for which you are applying (with or without reasonable accommodation?)

no     yes    

In case of accident or emergency, please notify:Emergency Contact Name

Emergency Contact Address

Emergency Contact Phone

Have you ever been convicted of a criminal offense other than minor traffic offenses? Including drug and alcohol related offenses.

no     yes    

If yes, describe in full, including date(s)

*Conviction Disclosure

Skills

If you are an experienced operator of office machines or equipment, please list:

If you are an experienced operator of plant machines or equipment, please list:

Education:

High School Name

High School Location

Did you graduate High School?

yes     no    

College Name

College Location

College Course of Study

College No. of Years Completed

Did you graduate College?

yes     no    

College Degree or Diploma

Graduate School Name

Graduate School Location

Graduate School Course of Study

Graduate School No. of Years Completed

Did you complete Graduate School

yes     no    

Graduate School Degree or Diploma

List scholastic achievements, organizations, organizations and internships

Membership in Professional or Civic Organizations (Exclude those which may disclose race, color, religion or national origin):

Military Service

Service U.S. Forces Branch:

Service U.S. Forces Rank:

Service U.S. Forces Begin Date:

Service U.S. Forces End Date:

Referral Source:

References:

Reference Name:

Reference Address:

Reference Phone No.:

Reference Length of Time Known:

Reference Name:

Reference Address:

Reference Phone No.:

Reference Length of Time Known:

Reference Name:

Reference Address:

Reference Phone No.:

Reference Length of Time Known:

In applying here for employment, it is understood that we reserve the privilege of contacting your past employers regarding references.

*Are you employed now?

yes     no    

*May we contact your present employer?

yes     no    

Employment History

Company Name

Company Address

Company Supervisor

Company Telephone

Job Title and Description of Work

Reason for Leaving

Employed from (month & year)

Employed to (month & year)

Compensation Begin:

Compensation End:

Company Name

Company Address

Company Supervisor

Company Telephone

Job Title and Description of Work

Reason for Leaving

Employed from (month & year)

Employed to (month & year)

Compensation Begin:

Compensation End:

Company Name

Company Address

Company Supervisor

Company Telephone

Job Title and Description of Work

Reason for Leaving

Employed from (month & year)

Employed to (month & year)

Compensation Begin:

Compensation End:

Company Name

Company Address

Company Supervisor

Company Telephone

Job Title and Description of Work

Reason for Leaving

Employed from (month & year)

Employed to (month & year)

Compensation Begin:

Compensation End:

Please Read Prior to Signing

Fields with (*) are compulsory.