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NOTICE TO APPLICANTS: FEDERAL AND STATE LAW REQUIRES THAT ALL APPLICATIONS BE CONSIDERED WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, AGE OR NATIONAL ORIGIN. WE BELIEVE IN AND FULLY SUPPORT THE PRINCIPLE OF EQUAL EMPLOYMENT OPPORTUNITY AND WILL FULFILL OUR OBLIGATION TO THE FULLEST

PERSONAL DATA
Last Name*
First Name*
Middle Name
Present Address
City, State, Zip
How Long?
Telephone
Cell Phone
Positions Applied For
Work Schedule Desired* Full TimePart Time
Rate Of Pay Expected:
Shift:
How Did You Hear Of This Opening?
Have You Worked With Us Before?* YesNo
When/How Long?
Previous Job Title
Reason For Leaving?
List Any Friends/Relatives Working With Us Now.
Are You Over 21?( If No, hire is subject to minimum legal age verification.)* YesNo
Sex*: MaleFemale
Height: Feet Inches
Weight: LBS.
Martial Status*: SingleMarriedSeparatedDivorcedWidowed
Nnumber Of Years Married
# Of Dependents Including Self
Have You Ever Been Bonded?* NoYes
When?
Have You Ever Been Convicted Of a Crime In The Past 10 Years (Excluding Traffic Violations)?* YesNo
If Yes, List Convictions And Status
Have You Had Any Serious Illness In The Past Five (5) Years?* YesNo
If Yes, Describe:


EDUCATION HISTORY(START FROM MOST RECENT AND FILL IN AS MUCH AS HISTORY AS POSSIBLE):
1. Educational Benchmark:
Graduated:
Major:
Grade Point Average:
School Information:
Name:
Address:
Comments:
2. Educational Benchmark:
Graduated:
Major:
Grade Point Average:
School Information:
Name:
Address:
Comments:
3. Educational Benchmark:
Graduated:
Major:
Grade Point Average:
School Information:
Name:
Address:
Comments:
4. Educational Benchmark:
Graduated:
Major:
Grade Point Average:
School Information:
Name:
Address:
Comments:
5. Educational Benchmark:
Graduated:
Major:
Grade Point Average:
School Information:
Name:
Address:
Comments:
EMPLOYMENT EXPERIENCE:

Start with you present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status
1. Employer Information:
Name:
Address:
Telephone Number:
Job Title:
Reason for Leaving:
Date Employed:
From
Starting Salary (In Dollars($)):
To
Ending Salary (In Dollars($)):
Details on Experience:
2. Employer Information:
Name:
Address:
Telephone Number:
Job Title:
Reason for Leaving:
Date Employed:
From
Starting Salary (In Dollars($)):
To
Ending Salary (In Dollars($)):
Details on Experience:
3. Employer Information:
Name:
Address:
Telephone Number:
Job Title:
Reason for Leaving:
Date Employed:
From
Starting Salary (In Dollars($)):
To
Ending Salary (In Dollars($)):
Details on Experience:
4. Employer Information:
Name:
Address:
Telephone Number:
Job Title:
Reason for Leaving:
Date Employed:
From
Starting Salary (In Dollars($)):
To
Ending Salary (In Dollars($)):
Details on Experience:
5. Employer Information:
Name:
Address:
Telephone Number:
Job Title:
Reason for Leaving:
Date Employed:
From
Starting Salary (In Dollars($)):
To
Ending Salary (In Dollars($)):
Details on Experience:
PERSONAL REFERENCES (LIST ONLY PERSONS WE MAY CONTACT):
1. Name
Address:
Relationship:
Home
Work
Cell
2. Name
Address:
Relationship:
Home
Work
Cell
3. Name
Address:
Relationship:
Home
Work
Cell
4. Name
Address:
Relationship:
Home
Work
Cell
5. Name
Address:
Relationship:
Home
Work
Cell
EMPLOYMENT APPLICANT RELEASE AND CONSENT

The purpose of this release is to allow FABRICATORS, INC. (Hereafter referred to as “Company”), Application Researchers, or their assigns, to obtain pre-employment information which may include any lawful investigation of my educational background and criminal, driving, credit, and employment histories, while maintaining compliance with all governmental laws.

I am aware I have the right to make a written request of Application Researchers, P. O. Box 11, Chattanooga, TN 37401-0011, (423) 265-6035, to obtain additional information regarding the nature and scope of the background check.

If the company considers the background check results unfavorable, I agree that the company may deny me the assignment or discharge me from employment. I release the company, its officers, agents, and employees from all liability resulting from the collection, use or disclosure of the information obtained during the above investigation.

I certify that the information contained within the employment application is complete and true. I have read this release and consent, understand its terms, realize its significance, and sign it voluntarily.

I am willingly providing the following information necessary for the above investigation, and understand that this information is being used for verification purposes only.

(Please Print, except for requested signature)
Applicant’s Name
First Name:
 Middle:
 Last:
SocialO Security Number:
Driver’s License Details:
State:
Number:

Signature of Applicant(PRINT YOUR NAME)
Date
Applicant’s Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days.

Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time, and that the Employer may discharge the Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulation of the employer.

Signature of Applicant(PRINT YOUR NAME)
Date

Applicant: Read and Sign Below

Prior to employment, every potential employee must complete a Drug Screening Test, and possibly a Pre-employment Physical during initial orientation. Testing requirements will be at employer’s discretion.

Signature of Applicant(PRINT YOUR NAME)
Date