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Name:
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_____________________________________________
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Date: _____________
mm-dd-yyyy
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Address:
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_____________________________________________
_____________________________________________
_____________________________________________
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Email:
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______________________________
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Phones:
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Home _____________ Work _____________ Cell _____________
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In an Emergency, notify:
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_______________________________Ph#: _________________
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Referred By:
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_______________________________
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Date of Birth: __________ City of
Birth
: _____________________
USA
Citizen: Y / N
Optional: mm-dd-yyyy
Can you present evidence of your USA citizenship? YES / NO
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Driver License <> State: ____________
#: _______________________________
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Date Issued: _______
mm-dd-yyyy
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Date Expires: _________
mm-dd-yyyy
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Have you ever been convicted for violation of any criminal offense? Y / N Date Convicted: ________
mm-dd-yyyy If YES, please explain: ___________________________________________________________
_____________________________________________________________________________
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Do you consider yourself medically fit & fully capable of crafting an aircraft propeller? Y / N
Any medical related items that may hinder training to safely process a hand-crafted product?
_________________________________________________________________________________
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How were you referred to us: ____________________ Have you ever worked for us before?
Y / N
List present/past employees that you know: ______________________ Relationship to employees: __________
Hours available for work: _____________________ Are you wanting PART-TIME or FULL-TIME work?
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Date you can Start: ____________ Can you work weekends? Y
/ N …holidays? Y / N
mm-dd-yyyy
Can you work evenings? Y / N Can
you work overtime? Y / N Would you consider Summer ONLY work? Y / N
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PLEASE READ & INITIAL EACH PARAGRAPH, then Sign below…
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and
ability. I understand that any omission (including any misstatement) of material fact on this application or any document used in the consideration of employment, can be grounds for rejection of this application and immediate expulsion if employed.
______ (initials)
I understand that once employed, my employment is not definite and can be terminated at any time either with or without prior notice, by myself or the company.
______ (initials)
I permit the company to research my references, record of employment, education etc, that is listed on this application or with the documents that have accompanied or been provided with this application (resume, etc).
______ (initials)
I further authorize the references provided to disclose any information related to my character or employment or education, without giving me prior notice of such disclosure.
______ (initials)
In addition, I release the company, my former employers and all others listed with my employment application, from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
______ (initials)
Your comments or concerns… ___________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
___________________________________ Date ________
Signature of Applicant
_______________________________________________
Applicant’s printed name (First Middle Last)
This section will be completed by the company…
Applicant’s Screening Test Score: ___________________
Reviewed & accepted by: ________________________________
Company Officer’s Signature
Officer’s Name: _______________________________
