Careers – Innovative Mechanical Solutions

An Equal Opportunity Employer

We do not discriminate on the basis of race, color, religion, national origin, sex, age, veteran status or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

All fields with an asterisk(*) require an answer. If not applicable please enter N/A.

Job Applied For*

Today's Date*

Enter date in format (mm/dd/yyyy)

Are you seeking:*

Full Time
Part Time
Temporary

When could you start work?*

Name*

First Middle Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you 18 years or older?*

Yes
No

If you are hired you may be required to submit proof of age.

If hired, can you furnish proof you are eligible to work in the U.S?*

Yes
No

Have you ever applied here before?*

Yes
No

If yes, when?

Have you ever been convicted of any law violation (except a minor traffic violation)?*

Yes
No

If yes, give details

(A "Yes" answer does not automatically disqualify you from employment, since the nature of the offense, date, and the job for which you are applying will also be considered.)

Have you missed any work during the past six months?*

Yes
No

If yes, how much and why?

Are you now or do you expect to be engaged in any other business or employment?*

Yes
No

If yes, please explain

List professional, trade, business or civic activities and offices held.

(Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability or other protected status.)

Do you have any physical conditions which would limit your performance of the job for which you are applying?*

Yes
No

If yes, please explain

Would you take a physical examination, if required?*

Yes
No

List Name and Addresses of Schools

High School or GED*

Number of Years Completed*

Diploma/Degree/Certificate*

Subjects Studied*

College or University*

Number of Years Completed*

Diploma/Degree/Certificate*

Subjects Studied*

Vocational or Technical*

Number of Years Completed*

Diploma/Degree/Certificate*

Subjects Studied*

What skills or additional training do you have that are related to the job for which you are applying?*

What machines or equipment can you operate that are related to the job for which you are applying?*

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references. PLEASE GIVE MONTH AND YEAR.

Name of Employer*

Supervisor*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Titles and Duties*

Start Date*

Enter date in format (mm/dd/yyyy)

End Date*

Enter date in format (mm/dd/yyyy)

Starting Pay*

Final Pay*

Reason For Leaving*

Name of Employer*

Supervisor*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Titles and Duties*

Start Date*

Enter date in format (mm/dd/yyyy)

End Date*

Enter date in format (mm/dd/yyyy)

Starting Pay*

Final Pay*

Reason For Leaving*

Name of Employer*

Supervisor*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Titles and Duties*

Start Date*

Enter date in format (mm/dd/yyyy)

End Date*

Enter date in format (mm/dd/yyyy)

Starting Pay*

Final Pay*

Reason For Leaving*

Name of Employer*

Supervisor*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Titles and Duties*

Start Date*

Enter date in format (mm/dd/yyyy)

End Date*

Enter date in format (mm/dd/yyyy)

Starting Pay*

Final Pay*

Reason For Leaving*

Have you worked or attended school under any other name?*

Yes
No

If yes, give names

Are you presently employed?*

Yes
No

If yes, may we contact your present employer?*

Yes
No

Have you ever been fired from a job or asked to resign?*

Yes
No

If yes, please explain

Give three references, not relatives or former employers.

Name*

First

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name*

First

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name*

First

Phone*

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may justify my dismissal if discovered at a later date.

By signing this application I give permission for a background check, motor vehicle record check and workers compensation background check to be ran against my name. I also understand that the results of these checks may influence any decision made by the company.

I understand that the employer may request an investigative consumer report from a consumer reporting agency. This report may include information as to my character, reputation, personal characteristics and mode of living obtained from interviews with neighbors, friends, former employers, schools and others. I understand I have a right to make a written request within a reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature and scope of the investigation.

I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations named in this application to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I understand that if I am extended an offer of employment, it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre or post employment drug screen.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my signature consent to these statements.

Signature*

Date*

Enter date in format (mm/dd/yyyy)

Email*

An Equal Opportunity Employer

List Name and Addresses of Schools

Give three references, not relatives or former employers.

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

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