Online Application - Spencer Plastics

Personal Information

Last Name *

First Name *

Middle

Home Phone *

Business Phone

Street Address *

Street Address

City

State/Province

Zip/Postal

Email Address *

Do you have a high school equivalency diploma:

Yes

No

Number of years of post high school education:

1

2

3

4

Education History

School Type *

School Name *

School Location *

Years Attended *

Did you graduate? *

Yes

No

Subjects Studied

Add School Remove School

Employment Desired

Position *

Date you can start *

Salary Desired *

$

Are you currently employed? *

Yes

No

May we inquire of your present employer? *

Yes

No

Have you ever applied to this company before? *

Yes

No

At which location did you apply?

When did you apply?

Employment History

Please list last 2 employers, starting with last one first.

Start Month *

Start Year *

Do you currently work here? *

Yes

No

End Month *

End Year *

Name of Employer *

Address of Employer *

Address of Employer

City

State/Province

Zip/Postal

Salary

$

Position *

Reason for Leaving *

Add Employment Remove Employment

General Information

Which shifts are you willing to accept:

Which Job status are you willing to accept?

Full-Time

Part-Time

Are you willing to travel?

No

Yes

Subjects of special study/research or special training/skills *

Have you ever served in the US Military? *

Yes

No

Military Branch *

Rank *

Years of Service *

References

Please give the names of 3 persons not related to you, whom you have known at least one year.

First Name *

Last Name *

Address *

Address

City

State/Province

Zip/Postal

Phone Number *

Business/Relationship *

Years Known *

Add Reference Remove Reference

Miscellaneous Information

Compliance with the Immigration Reform and Control Act: Are you legally eligible for employment in the United States?

Yes

No

Prior Convictions: Have you ever been convicted of a felony?

Yes

No

If Yes, Please explain...

Additional Notes

Additional Notes *

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 and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

Today's Date *

Signature *

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